Healthcare Provider Details

I. General information

NPI: 1528972304
Provider Name (Legal Business Name): THE NIGHT MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 N ASHLAND AVE STE 2000
CHICAGO IL
60622-1412
US

IV. Provider business mailing address

1735 N ASHLAND AVE STE 2000
CHICAGO IL
60622-1412
US

V. Phone/Fax

Practice location:
  • Phone: 773-784-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEREK RAY MA
Title or Position: CLINICAL SUPERVISOR
Credential:
Phone: 312-996-7800