| Uih-mile Square Health Center At South Shore | |
|
7131 S. Jeffrey Blvd Uih-mile Square Health Center At South Shore Chicago IL 60649-2497 | |
| (773) 256-0526 | |
| (312) 413-7812 |
| Full Name | Uih-mile Square Health Center At South Shore |
|---|---|
| Speciality | Clinic/Center |
| Location | 7131 S. Jeffrey Blvd, 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 South Shore 1220 S. Wood Street Uih-mile Square Health Center Chicago IL 60608-1202 Ph: (312) 413-1261 | Uih-mile Square Health Center At South Shore 7131 S. Jeffrey Blvd Uih-mile Square Health Center At South Shore Chicago IL 60649-2497 Ph: (773) 256-0526 |
| NPI Number | 1760400170 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 3072422716 |
|---|---|
| Medicare Enrollment ID | O20051229000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760400170 | NPI | - | NPPES |
| BCBS PROVIDER | Other | IL | 1622185 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
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