MEDICARE: THE NIGHT MINISTRY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	251K00000X	Public Health or Welfare Agency
3	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1316356850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NIGHT MINISTRY

Provider Business Mailing Address
First Line	:	1735 N ASHLAND AVE STE 2000
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-1412
Country	:	US
Telephone Number	:	773-784-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 N ASHLAND AVE STE 2000
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-1412
Country	:	US
Telephone Number	:	773-784-9000
Fax Number	:

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

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	05/18/2025

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Directions to “THE NIGHT MINISTRY ” Practice Location

Language	Start Address	Practice Location

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