NPIMap

Organization Active NPI

Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1831170059
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEAR NORTH HEALTH SERVICE CORPORATION
Practice address
800 N Kedzie Ave
Chicago, IL 60651-4100
Phone
(773) 826-3450
Fax
(773) 829-3993
NPI assigned
Nov 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Mrs. Berneice Mills-Thomas
Title
Executive Director
Phone
(312) 337-1073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

800 N Kedzie Ave
Chicago, IL 60651-4100

Mailing address

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

Other names 1

  • Louise Landau Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000456 IL Part B Supplier - Clinic/Group Practice 9638165749 Receives reassigned benefits from 43 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1006174Louise Landau Health Center800 N Kedzie Ave, Chicago, IL 60651Provider-performed microscopyNov 11, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1831170059",
    "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": "606102089",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514100",
            "telephone_number": "773-826-3450",
            "fax_number": "773-829-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAR NORTH HEALTH SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "MILLS-THOMAS",
        "authorized_official_first_name": "BERNEICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-337-1073",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louise Landau Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Louise Landau Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.