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CHC33649-01 INNER CITY MUSLIM ACTION NETWORK (Active)
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Main Details
Name
INNER CITY MUSLIM ACTION NETWORK
Subdivision Name
IMAN - Youth and Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029619
340B ID
CHC33649-01
Grant Number
H80CS33649
Additional Details
Current Program Status
Active
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
6/11/2020
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Inner-city Muslim Action Network
Maysoon Haleem, Director of Revenue Cycle
(773) 464-4626
Primary Contact
Inner-City Muslim Action Network (IMAN)
Yesenia Valle, Health Information Coordinator
(773) 464-4626 Ext: 398
Addresses
Street Address
2749 W 63rd St
Chicago, IL 60629-2342
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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