MILE SQUARE ENGLEWOOD/COOK SATELLITE HEALTH AND WELLNESS CENTER (NPI# 1487193181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487193181 |
Entity Type | Organization |
Organization Name | MILE SQUARE ENGLEWOOD/COOK SATELLITE HEALTH AND WELLNESS CENTER |
Practice Address |
8150 S Bishop St Chicago IL 60620-3854 |
Practice Telephone | 7737831370 |
Practice Fax Number | 7737831356 |
Mailing Telephone | 7737831370 |
Mailing Fax Number | 7737831356 |
Enumeration Date | 2017-02-15 |
Last Update Date | 2019-09-04 |
Authorized Official Name | MR. HENRY TAYLOR (EXCETIVE DIRECTOR) |
Authorized Official Telephone | 3124131261 |
Is Organization Subpart | Y |
Parent Organization Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Street Address |
8150 S BISHOP ST |
City | CHICAGO |
State | IL |
Zip Code | 60620-3854 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295358182 | Kenya Reed | Developmental Therapist | 8920 S Loomis St, Apt 116, Chicago, IL 60620 | 2020-05-26 |
1255820031 | Bnd Transportation | Non-emergency Medical Transport (VAN) | 9436 S Laflin St # 3, Chicago, IL 60620 | 2018-05-07 |
1386132520 | It Takes A Community LLC | Day Training, Developmentally Disabled Services | 9046 S Justine St, Chicago, IL 60620 | 2018-04-24 |
1598200164 | Julie Rae Scott | Social Worker | 400 W 76th Street, Suite 226, Chicago, IL 60620 | 2017-01-05 |
1033521968 | James Towns | Clinical Exercise Physiologist | 9247 S. Wentworth, Chicago, IL 60620 | 2014-05-27 |
1629488788 | Renee Victoria Green | Counselor | 9415 S. Lowe, Chicago, IL 60620 | 2014-04-29 |
1588085138 | Steven Hsu | Chiropractor | 9415 S. Western Ave., Suite 207, Chicago, IL 60620 | 2013-12-30 |
1164791810 | Richard Kasper | Pharmacist | 7901 S Western, Chicago, IL 60620 | 2011-12-27 |
1992089916 | Michawn Willis | Pharmacist | 8636 S Ashland, Chicago, IL 60620 | 2011-10-10 |
1770884314 | Gjm Consultant Services PC | Home Health | 400 W. 76th Street, Suite 202, Chicago, IL 60620 | 2010-11-13 |
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Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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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 |
1649718594 | Mile Square Drake Health and Wellness Center | Clinic/Center | 2710 S Dearborn St, Chicago, IL 60616-2684 | 2017-02-10 |
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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.