Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CUSH MVUDUDU (CONTROLLER)
(312) 337-1073
Entity
Organization
Contact information
Practice address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2003
(312) 337-1073
(312) 337-5264
Mailing address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2003
(312) 337-1073
(312) 337-5264
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
10/17/2018
Last updated
01/27/2023
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