Organization
NEW HOPE COMMUNITY SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIA M BODLEY (MEDICAL BILLING MANAGEMENT)
(773) 737-9555
Entity
Organization
Contact information
Practice address
2559 W 79TH ST, CHICAGO, IL 60652-1751
(773) 737-9555
Mailing address
2559 W 79TH ST, CHICAGO, IL 60652-1751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001356519714
—
IL
Enumeration date
06/12/2019
Last updated
06/12/2019
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