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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