Organization
NEAR NORTH HEALTH SERVICE CORPORATION
Active
Parent organization
NEAR NORTH HEALTH SERVICE CORPORATION
Other names
NEAR NORTH HEALTH CORPORATION MOBILE UNIT
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEAR NORTH HEALTH SERVICE CORPORATION
Authorized official
CUSH MVUDUDU (CONTROLLER)
(312) 337-1073
Entity
Organization
Contact information
Practice address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2003
(312) 337-1073
(312) 337-5264
Mailing address
1276 N CLYBOURN AVE, CHICAGO, IL 60610-2003
(331) 643-5238
(312) 337-1794
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
02/02/2023
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