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NEAR NORTH HEALTH SERVICE CORPORATION NPI 1922237890


NPI Information

NPI: 1922237890
Provider Name: NEAR NORTH HEALTH SERVICE CORPORATION

Doing Business As: REAVIS SCHOOL BASED HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 14D2000620

Address:
834 E 50TH ST
CHICAGO, IL
ZIP 60615
Phone: (773) 358-6767
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NEAR NORTH HEALTH SERVICE CORPORATION is a federally qualified health center (fqhc) clinic center in Chicago, IL. NEAR NORTH HEALTH SERVICE CORPORATION NPI is 1922237890. The provider is registered as an organization entity type.
The provider Is Doing Business As Reavis School Based Health Center.

The provider's business location address is:

834 E 50TH ST
CHICAGO, IL
ZIP 60615-620
Phone: (773) 358-6767

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 CLIA number assigned to this NPI record is 14D2000620 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/13/2009 and was last updated on 7/26/2021.


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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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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