NEAR NORTH HEALTH SERVICE CORPORATION (NPI# 1720404494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720404494 |
| Entity Type | Organization |
| Organization Name | NEAR NORTH HEALTH SERVICE CORPORATION |
| Other Organization Name | NORTH AND KOSTNER HEALTH CENTER |
| Practice Address |
1520 N Kostner Ave Chicago IL 60651-1610 |
| Practice Telephone | 3123371073 |
| Practice Fax Number | 3123377616 |
| Mailing Telephone | 3123371073 |
| Mailing Fax Number | 3123377616 |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |
| Authorized Official Name | MS. BERNEICE MILLS-THOMAS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3123371073 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
2307802 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BUSINESS LICENSE | 2307802 | 01 |
| Other Name | Type Code |
|---|---|
| NORTH AND KOSTNER HEALTH CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659725133 | Near North Health Service Corporation | Clinic/Center | 4501 N Sheridan Rd, Chicago, IL 60640-5608 | 2016-04-20 |
| 1922237890 | Near North Health Service Corporation | Clinic/Center | 834 E 50th St, Chicago, IL 60615-2620 | 2009-07-13 |
| 1831170059 | Near North Health Service Corporation | Clinic/Center | 800 N Kedzie Ave, Chicago, IL 60651-4100 | 2005-11-07 |
| 1821079088 | Near North Health Service Corporation | Clinic/Center | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2005-11-07 |
| 1346221553 | Near North Health Service Corporation | Clinic/Center | 4259 S Berkeley Ave, Chicago, IL 60653-3030 | 2005-11-07 |
| 1073594297 | Near North Health Service Corporation | Clinic/Center | 4829 S Cottage Grove Ave, Chicago, IL 60615-1600 | 2005-11-07 |
| 1326514365 | Near North Health Service Corporation | Case Management | 1276 N Clybourn Ave, Chicago, IL 60610-2003 | 2018-10-17 |
| 1871749473 | Near North Health Service Corporation | Clinic/Center | 1276 N Clybourn Ave, Chicago, IL 60610-2089 | 2008-08-14 |
| 1417156043 | Near North Health Service Corporation | Clinic/Center | 4867 N Broadway, Chicago, IL 60614 | 2007-07-13 |
| Street Address |
1520 N KOSTNER AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60651-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013234236 | Kerri Michelle Lockhart | Pediatrics | 1520 N Kostner Ave, Chicago, IL 60651-1610 | 2010-04-27 |
| 1003422437 | Lisett Tito | Social Worker | 1520 N Kostner Ave, Chicago, IL 60651-1610 | 2020-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215474978 | Kanesha Walker Amaro | Counselor | 5910 W Division, Chicago, IL 60651 | 2017-01-19 |
| 1639628415 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 3520 West Grand, Chicago, IL 60651 | 2016-09-22 |
| 1326596321 | Giselle Tisha Wallace | Nurse's Aide | 5809 W Rice, Chgo, IL 60651 | 2016-09-19 |
| 1811385214 | Jeanette Rodriguez | Social Worker | 1116 N Kedzie Av. Office#257, Association House of Chicago, Chicago, IL 60651 | 2015-01-07 |
| 1801147475 | Diane Dickens-rogers | Massage Therapist | 5700 W. Chicago Ave., Chicago, IL 60651 | 2012-09-24 |
| 1891045241 | Association House of Chicago | Residential Treatment Facility, Emotionally Disturbed Children | 1900 North Sawyer Avenue, Chicago, IL 60651 | 2012-09-13 |
| 1770860983 | Christine C Osborne | Pharmacist | 1541 N.central Ave, Chicago, IL 60651 | 2011-11-16 |
| 1629206388 | Habilitative Systems Inc | Case Management | 1049 N Drake Ave, Chicago, IL 60651 | 2009-07-01 |
| 1841428547 | Habilitative Systems, Inc. | Case Management | 4234 W Potomac Ave, Chicago, IL 60651 | 2009-07-01 |
| 1306074000 | Habilitative Systems, Inc | Case Management | 915 N Massasoit Ave, Chicago, IL 60651 | 2009-07-01 |
| Find all providers in zip 60651 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 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 |
| Find all providers in CHICAGO | ||||
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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.