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NPI Code Detail

MEDICARE: NEW HOPE COMMUNITY SERVICE CENTER

MEDICARE: NEW HOPE COMMUNITY SERVICE CENTER
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
1207R00000XInternal Medicine Physician
2208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447819578
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW HOPE COMMUNITY SERVICE CENTER
Provider Business Mailing Address
First Line : 2559 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-1751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2559 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-1751
Country : US
Telephone Number : 773-737-9555
Fax Number :
Authorized Official
Title or Position : MEDICAL BILLING MANAGEMENT
Name : CLAUDIA M BODLEY
Credential :
Telephone Number : 773-737-9555
Provider Enumeration Date : 06/12/2019
Last Update Date : 06/12/2019

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Directions to “NEW HOPE COMMUNITY SERVICE CENTER ” Practice Location

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