# IMANI COMMUNITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053107813
- **Authorized official:** DR. JANICE MWANIKI MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (312) 823-7793

## Contact information

- **Practice address:** 502 W 138TH ST, RIVERDALE, IL 60827-1611
- **Practice address phone:** (312) 763-6162
- **Mailing address:** 502 W 138TH ST, RIVERDALE, IL 60827-1611
- **Mailing address phone:** (312) 763-6162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/17/2025
- **Last updated:** 07/01/2026