MEDICARE: CARVER MILITARY ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1053622043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARVER MILITARY ACADEMY

Provider Business Mailing Address
First Line	:	1029 E 130TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60628-6908
Country	:	US
Telephone Number	:	773-995-6300
Fax Number	:	773-995-7985

Provider Business Practice Location Address
First Line	:	13100 S DOTY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60827-1597
Country	:	US
Telephone Number	:	773-535-5357
Fax Number	:	773-995-7985

Authorized Official
Title or Position	:	CEO
Name	:	VERONICA CLARKE
Credential	:
Telephone Number	:	773-928-5090

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	01/11/2023

Similar Medicare Providers

1306004809 — DR. MICHAEL BERTUCCI
Practice Location Address:

2701 N CLARK ST
CHICAGO, IL
60614-1597

Practice Phone: 773-935-3762
Practice Fax:

1598720088 — INFINITE IMAGING INC
Practice Location Address:

1029 E 30TH ST
CHICAGO, IL
60827

Practice Phone: 773-928-6300
Practice Fax: 773-928-6850

1093818148 — ALTGELD GARDEN DRUG CO.
Practice Location Address:

974 E 133RD ST
CHICAGO, IL
60827-1428

Practice Phone: 773-264-0787
Practice Fax: 773-264-1191

1609939347 — DR. CHRISTIAN ENYINNA OKEZIE M.D.
Practice Location Address:

972 E 133RD ST
CHICAGO, IL
60827-1428

Practice Phone: 773-291-0035
Practice Fax: 773-291-0037

1164897302 — HELPING HANDS ENTERPRISES LLC
Practice Location Address:

13246 S LANGLEY AVE
CHICAGO, IL
60827-1336

Practice Phone: 312-730-3618
Practice Fax:

1356716591 — NONI ARNOLD
Practice Location Address:

214 E 134TH ST
CHICAGO, IL
60827-1808

Practice Phone: 312-730-3618
Practice Fax:

Directions to “CARVER MILITARY ACADEMY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.