| Ui Health Mile Square Health Center Back Of The Yards Dental | |
|
4634 S Bishop St Chicago IL 60609-3240 | |
| (312) 355-5570 | |
| Not Available |
| Full Name | Ui Health Mile Square Health Center Back Of The Yards Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 4634 S Bishop St, Chicago, Illinois |
| Authorized Official Name and Position | Henry Taylor (CEO) |
| Authorized Official Contact | 3124131261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ui Health Mile Square Health Center Back Of The Yards Dental 1220 S Wood St Chicago IL 60608-1202 Ph: (312) 413-3282 | Ui Health Mile Square Health Center Back Of The Yards Dental 4634 S Bishop St Chicago IL 60609-3240 Ph: (312) 355-5570 |
| NPI Number | 1124787908 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 02/08/2022 |
| Medicare PECOS PAC ID | 3072422716 |
|---|---|
| Medicare Enrollment ID | O20220711002856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124787908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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