Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Other names
Winfield-Moody Health Center
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 60610-2089
(312) 337-1073
(312) 337-7616
Mailing address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2089
(312) 337-1073
(312) 337-7616
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A09410001A
IL
Other
Enumeration date
08/14/2008
Last updated
01/27/2023
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