MEDICARE: NEAR NORTH HEALTH SERVICE CORPORATION

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	:	1962074500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEAR NORTH HEALTH SERVICE CORPORATION

Provider Business Mailing Address
First Line	:	1276 N CLYBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-2089
Country	:	US
Telephone Number	:	312-337-1073
Fax Number	:	312-337-5264

Provider Business Practice Location Address
First Line	:	2844 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7401
Country	:	US
Telephone Number	:	773-661-3349
Fax Number	:	312-235-4257

Authorized Official
Title or Position	:	CEO
Name	:	BERNEICE MILLS-THOMAS
Credential	:
Telephone Number	:	312-337-1073

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/21/2021

Similar Medicare Providers

1356389381 — DR. ALEX LIMA M.D.
Practice Location Address:

2834 N MILWAUKEE AVE
CHICAGO, IL
60618-7401

Practice Phone: 773-772-1139
Practice Fax: 773-772-9260

1578650230 — MRS. RAFAELA MUNOZ ULRICH MD
Practice Location Address:

2844 N MILWAUKEE AVENUE
CHICAGO, IL
60618-7401

Practice Phone: 773-252-1344
Practice Fax: 773-252-5512

1952592123 — THE PROFESSIONAL CENTER INC
Practice Location Address:

2834 N MILWAUKEE AVE
CHICAGO, IL
60618-7401

Practice Phone: 773-772-1139
Practice Fax: 773-772-9260

1619590601 — JENIFFER ELIZABETH LIMA MD
Practice Location Address:

2834 N MILWAUKEE AVE
CHICAGO, IL
60618-7401

Practice Phone: 773-772-1139
Practice Fax:

1124036264 — MS. MICHELLE GONWA HEYDEN MAAT, LCPC
Practice Location Address:

180 N MICHIGAN AVE , SUITE 905
CHICAGO, IL
60601-7401

Practice Phone: 312-213-2226
Practice Fax:

1487640355 — ROBERT W. BUCHANAN, M.D. S.C.
Practice Location Address:

180 N MICHIGAN AVE , SUITE 1010
CHICAGO, IL
60601-7401

Practice Phone: 312-726-7729
Practice Fax: 312-726-7765

Directions to “NEAR NORTH HEALTH SERVICE CORPORATION ” 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.