MILE SQUARE DRAKE HEALTH AND WELLNESS CENTER (NPI# 1649718594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649718594 |
Entity Type | Organization |
Organization Name | MILE SQUARE DRAKE HEALTH AND WELLNESS CENTER |
Practice Address |
2710 S Dearborn St Chicago IL 60616-2684 |
Practice Telephone | 3129490379 |
Practice Fax Number | 3129491473 |
Mailing Telephone | 3129490379 |
Mailing Fax Number | 3129491473 |
Enumeration Date | 2017-02-10 |
Last Update Date | 2017-02-10 |
Authorized Official Name | MR. HENRY TAYLOR (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3124121261 |
Is Organization Subpart | Y |
Parent Organization Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Street Address |
2710 S DEARBORN ST |
City | CHICAGO |
State | IL |
Zip Code | 60616-2684 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346707254 | The Board of Trustees of The University of Illinois | Clinic/Center | 2710 S Dearborn St, Chicago, IL 60616-2684 | 2019-02-27 |
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1215499777 | Mashaal F Ikram | Student in an Organized Health Care Education/Training Program | Mercy Hospital and Medical Center, 2525 South Michigan Avenue, Chicago, IL 60616 | 2019-04-03 |
1891254223 | Towayn Heaven | Acupuncturist | 2018 S Michigan Ave, Chicago, IL 60616 | 2019-03-15 |
1689131518 | Abhishek Santos Pandya | Internal Medicine | 2525 S Michigan Ave., Mercy Hospital and Medical Center, Chicago, IL 60616 | 2019-02-27 |
1144703992 | Katelyn Michelle St Martin | Physician Assistant | 2850 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-09-07 |
1902383953 | Healing Empowering & Learning Professionals LLC | Clinic/Center | 2930 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-07-23 |
1437644812 | Puja Bhagwakar | Dentist | 1620 S Michigan Ave Unit 704, Chicago, IL 60616 | 2018-06-27 |
1821589110 | David Alexander Sousa Frias | Internal Medicine | 2525 Michigan Ave, Mercy Hospital At Medical Center, Chicago, IL 60616 | 2018-05-23 |
1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
Find all providers in zip 60616 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
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1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.