| Uih-mile Square Health Center At Englewood | |
|
641 W. 63rd St Uih-mile Square Health Center At Englewood Chicago IL 60621-2032 | |
| (312) 413-4070 | |
| (312) 413-7812 |
| Full Name | Uih-mile Square Health Center At Englewood |
|---|---|
| Speciality | Clinic/Center |
| Location | 641 W. 63rd 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 |
|---|---|
| Uih-mile Square Health Center At Englewood 1220 S. Wood Street Uih-mile Square Health Center Chicago IL 60608-1202 Ph: (312) 413-1261 | Uih-mile Square Health Center At Englewood 641 W. 63rd St Uih-mile Square Health Center At Englewood Chicago IL 60621-2032 Ph: (312) 413-4070 |
| NPI Number | 1346596327 |
|---|---|
| Provider Enumeration Date | 07/27/2012 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 3072422716 |
|---|---|
| Medicare Enrollment ID | O20121126000551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346596327 | NPI | - | NPPES |
| 1622185 | Other | IL | BLUE CROSS |
| 1622185 | Other | IL | BCBS PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
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