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Uptown Neighborhood Health Center 845 W Wilson Chicago IL 60640 | |
| (312) 744-1938 | |
| (312) 744-5023 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | Uptown Neighborhood Health Center, Chicago, Illinois |
| Authorized Official Name and Position | Matthew W. Beaudet (FIRST DEPUTY COMMISSIONER) |
| Authorized Official Contact | 3127479889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Chicago Department Of Public Health 333 S State Street Revenue #200 Chicago IL 60604 Ph: (312) 747-9443 | Uptown Neighborhood Health Center 845 W Wilson Chicago IL 60640 Ph: (312) 744-1938 |
| NPI Number | 1477545614 |
|---|---|
| Provider Enumeration Date | 08/15/2005 |
| Last Update Date | 04/28/2010 |
| Medicare PECOS PAC ID | 4486540929 |
|---|---|
| Medicare Enrollment ID | O20040303001160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477545614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Illinois) | Primary |
| Provider Name | Juanita M Mosquera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003927229 PECOS PAC ID: 3375549710 Enrollment ID: I20061009000168 |
| Provider Name | Nancy L Gajewski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538256276 PECOS PAC ID: 6901990860 Enrollment ID: I20070922000048 |
| Provider Name | Shilynda S Tolbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558334532 PECOS PAC ID: 6204923808 Enrollment ID: I20071029000736 |
| Provider Name | Angela B Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083680797 PECOS PAC ID: 8729121959 Enrollment ID: I20100216000242 |
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