Organization Active NPI

Near North Health Service Corporation

  • Public Health or Welfare Agency
  • Chicago, IL
National Provider Identifier
1033838214
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
NEAR NORTH HEALTH SERVICE CORPORATION
Practice address
1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone
(331) 643-5238
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wanda Denise SmithNPI 1114550688
Title
Patient Revenue Manager
Phone
(312) 337-1073

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Public Health or Welfare Agency 251K00000X Primary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X
Rural Health Clinic/Center 261QR1300X
Meals Provider 174200000X

Addresses

Primary practice location

1276 N Clybourn Ave
Chicago, IL 60610-2003

Mailing address

1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone (331) 643-5238

National Provider Directory

National Provider Directory
Tax ID family
Near North Health Servi11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1033838214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "331-643-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "331-643-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAR NORTH HEALTH SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WANDA DENISE",
        "authorized_official_title_or_position": "PATIENT REVENUE MANAGER",
        "authorized_official_telephone_number": "312-337-1073"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.