NEAR NORTH HEALTH SERVICE CORPORATION (NPI# 1346221553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346221553 |
| Entity Type | Organization |
| Organization Name | NEAR NORTH HEALTH SERVICE CORPORATION |
| Other Organization Name | NEAR NORTH HEALTH SERV KOMED |
| Practice Address |
4259 S Berkeley Ave Chicago IL 60653-3030 |
| Mailing Address |
1276 N Clybourn Ave Chicago IL 60610-2089 |
| Practice Telephone | 7732687600 |
| Practice Fax Number | 7732689088 |
| Mailing Telephone | 7732687600 |
| Mailing Fax Number | 7732689088 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2011-03-03 |
| Authorized Official Name | MRS. BERNEICE MILLS-THOMAS (EXECUTIVE) |
| Authorized Official Telephone | 3123371073 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Near North Health Serv Komed | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659725133 | Near North Health Service Corporation | Clinic/Center | 4501 N Sheridan Rd, Chicago, IL 60640-5608 | 2016-04-20 |
| 1922237890 | Near North Health Service Corporation | Clinic/Center | 834 E 50th St, Chicago, IL 60615-2620 | 2009-07-13 |
| 1831170059 | Near North Health Service Corporation | Clinic/Center | 800 N Kedzie Ave, Chicago, IL 60651-4100 | 2005-11-07 |
| 1821079088 | Near North Health Service Corporation | Clinic/Center | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2005-11-07 |
| 1073594297 | Near North Health Service Corporation | Clinic/Center | 4829 S Cottage Grove Ave, Chicago, IL 60615-1600 | 2005-11-07 |
| 1326514365 | Near North Health Service Corporation | Case Management | 1276 N Clybourn Ave, Chicago, IL 60610-2003 | 2018-10-17 |
| 1720404494 | Near North Health Service Corporation | Clinic/Center | 1520 N Kostner Ave, Chicago, IL 60651-1610 | 2014-03-05 |
| 1871749473 | Near North Health Service Corporation | Clinic/Center | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2008-08-14 |
| 1417156043 | Near North Health Service Corporation | Clinic/Center | 4867 N Broadway, Chicago, IL 60614 | 2007-07-13 |
| Street Address |
4259 S BERKELEY AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60653-3030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808407 | Destenii Thomas Anderson | Dental Hygienist | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2020-10-15 |
| 1659914935 | Beeba Achamma Mathew | Nurse Practitioner | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2019-10-19 |
| 1821630054 | Near North Health | Dental Hygienist | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2019-10-09 |
| 1245885474 | Miguel Bautista | Counselor | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2019-08-05 |
| 1417330556 | Samantha Kufta | Dentist | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2015-07-07 |
| 1588091276 | Ayo Renee Odior | Nurse Practitioner | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2013-09-26 |
| 1447691977 | Mary Caitlin Gondek | Nurse Practitioner | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2013-07-12 |
| 1124373899 | Adewale Olailan Lawal | Dentist | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2012-07-19 |
| 1639437924 | American Pharmaceutical Drugs Inc | Pharmacy | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2012-04-24 |
| 1699009654 | Leah Margaret Van Slambrouck | Pediatrics | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2009-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
| 1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
| 1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
| 1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
| 1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
| 1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
| 1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
| Find all providers in zip 60653 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
| 1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
| 1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
| 1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
| 1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.