MEDICARE: NEW AGE SERVICES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		IL

General Provider Information

NPI Number	:	1437692639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW AGE SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	1330 S KOSTNER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-1152
Country	:	US
Telephone Number	:	773-542-1150
Fax Number	:	773-542-1175

Provider Business Practice Location Address
First Line	:	1330 S KOSTNER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-1152
Country	:	US
Telephone Number	:	773-542-1150
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TONYIA P WINSTON
Credential	:	PHD
Telephone Number	:	773-542-1150

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	09/16/2025

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Directions to “NEW AGE SERVICES CORPORATION ” Practice Location

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