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CH053280 NEAR NORTH HEALTH SERVICE CORPORATION, THE (Active)
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Main Details
Name
NEAR NORTH HEALTH SERVICE CORPORATION, THE
Subdivision Name
WINFIELD MOODY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003332
340B ID
CH053280
Grant Number
H80CS00194
Additional Details
Current Program Status
Active
Registration Date
8/10/2007
Participating Start Date
10/1/2007
Participating Approval Date
8/13/2007
Last Recertification Date
2/23/2025
Contacts
Authorizing Official
Near North Health
Triste Lieteau Smith, CEO
(312) 337-1073 Ext: 4201
Primary Contact
Near North Health Service Corporation
Cush Mvududu, Controller
(312) 337-1073 Ext: 4216
Addresses
Street Address
1276 N Clybourn Ave
Chicago, IL 60610-2089
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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