Healthcare Provider Details

I. General information

NPI: 1619895992
Provider Name (Legal Business Name): MOVING ON UP SUPPORTIVE HOUSING NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 E 72ND PL STE 4C
CHICAGO IL
60619-1407
US

IV. Provider business mailing address

1343 E 72ND PL STE 4C
CHICAGO IL
60619-1407
US

V. Phone/Fax

Practice location:
  • Phone: 888-655-3382
  • Fax: 217-336-7778
Mailing address:
  • Phone: 888-655-3382
  • Fax: 217-336-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL D MUHAMMAD
Title or Position: PRESIDENT
Credential:
Phone: 888-655-3382