NPIMap

Organization Active NPI

Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1962074500
Registry record updated Jul 21, 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
2844 N Milwaukee Ave
Chicago, IL 60618-7401
Phone
(773) 661-3349
Fax
(312) 235-4257
NPI assigned
Jul 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Berneice Mills-Thomas
Title
Ceo
Phone
(312) 337-1073

Specialties & licenses 1

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

Addresses

Primary practice location

2844 N Milwaukee Ave
Chicago, IL 60618-7401

Mailing address

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

Other names 1

  • Razem 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.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1962074500",
    "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": "312-337-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187401",
            "telephone_number": "773-661-3349",
            "fax_number": "312-235-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAR NORTH HEALTH SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MILLS-THOMAS",
        "authorized_official_first_name": "BERNEICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-337-1073"
    },
    "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": "Razem 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 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.