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NEAR NORTH HEALTH SERVICE CORPORATION NPI 1871749473


NPI Information

NPI: 1871749473
Provider Name: NEAR NORTH HEALTH SERVICE CORPORATION

Doing Business As: WINFIELD-MOODY HEALTH CENTER

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1276 N CLYBOURN AVE
CHICAGO, IL
ZIP 60610
Phone: (312) 337-1073
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NEAR NORTH HEALTH SERVICE CORPORATION is a rehabilitation and substance use disorder clinic center in Chicago, IL. NEAR NORTH HEALTH SERVICE CORPORATION NPI is 1871749473. The provider is registered as an organization entity type.
The provider Is Doing Business As Winfield-moody Health Center.

The provider's business location address is:

1276 N CLYBOURN AVE
CHICAGO, IL
ZIP 60610-089
Phone: (312) 337-1073
Fax: (312) 337-7616

The provider's authorized official is Berneice Mills-thomas .
The authorized official title is Executive Director and has the following contact phone number (312) 337-1073.

The enumeration date for this NPI number is 8/14/2008 and was last updated on 8/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderA09410001AILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========002MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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