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General NPI Number Information
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NPI Number | 1316356850
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Entity Type | Organization
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Legal Business Name | THE NIGHT MINISTRY
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 05/18/2025
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Provider Practice Location Address
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Address Line | 1735 N ASHLAND AVE STE 2000
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City | CHICAGO
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State | IL
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Zip | 60622-1412
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Country | US
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Telephone | 773-784-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 N ASHLAND AVE STE 2000
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City | CHICAGO
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State | IL
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Zip | 60622-1412
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Country | US
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Telephone | 773-784-9000
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | DEREK RAY MA
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Credential | DNP, APRN, FNP-BC
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Telephone | 312-996-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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