Healthcare Provider Details

I. General information

NPI: 1932027158
Provider Name (Legal Business Name): NEW AGE SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

386 N YORK ST STE 209
ELMHURST IL
60126-2367
US

IV. Provider business mailing address

1330 S KOSTNER AVE
CHICAGO IL
60623-1152
US

V. Phone/Fax

Practice location:
  • Phone: 630-501-1742
  • Fax:
Mailing address:
  • Phone: 773-542-1150
  • Fax:

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: DR. TONYIA WINSTON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PHD
Phone: 773-542-1150