Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Other names
Near North Health Serv Komed
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERNEICE MILLS-THOMAS (EXECUTIVE)
(312) 337-1073
Entity
Organization
Contact information
Practice address
4259 S BERKELEY AVE, CHICAGO, IL 60653-3030
(773) 268-7600
(773) 268-9088
Mailing address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2089
(773) 268-7600
(773) 268-9088
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/07/2005
Last updated
07/21/2021
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