Healthcare Provider Details

I. General information

NPI: 1114723921
Provider Name (Legal Business Name): UJIMA HUNGER COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 W LAKE ST STE 3
CHICAGO IL
60661-1034
US

IV. Provider business mailing address

661 W LAKE ST STE 3
CHICAGO IL
60661-1034
US

V. Phone/Fax

Practice location:
  • Phone: 314-584-8592
  • Fax:
Mailing address:
  • Phone: 314-584-8592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name: BRIAN WIEHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-584-8592