Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Other names
Sunnyside Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTE SMITH (CHIEF EXECUTIVE OFFICER)
(312) 337-1073
Entity
Organization
Contact information
Practice address
4140 N BROADWAY ST, CHICAGO, IL 60613-2121
(773) 878-8098
Mailing address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2089
(312) 337-1073
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/20/2016
Last updated
10/15/2024
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