Healthcare Provider Details

I. General information

NPI: 1194817809
Provider Name (Legal Business Name): NEW HOPE COMMUNITY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 E 75TH ST STE 110
CHICAGO IL
60649-3646
US

IV. Provider business mailing address

2011 E 75TH ST STE 110
CHICAGO IL
60649-3646
US

V. Phone/Fax

Practice location:
  • Phone: 773-752-7796
  • Fax: 773-785-2091
Mailing address:
  • Phone: 773-752-7796
  • Fax: 773-785-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SOHAN P JOSHI
Title or Position: CHAIRMAN
Credential:
Phone: 77317527796