Healthcare Provider Details

I. General information

NPI: 1316356850
Provider Name (Legal Business Name): THE NIGHT MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
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: 773-784-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DEREK RAY MA
Title or Position: CLINICAL SUPERVISOR
Credential: DNP, APRN, FNP-BC
Phone: 312-996-7800