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CH05328C Near North Health Service Corporation, The (Active)
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Main Details
Name
Near North Health Service Corporation, The
Subdivision Name
Sunnyside Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-034174
340B ID
CH05328C
Grant Number
H80CS00194
Additional Details
Current Program Status
Active
Registration Date
4/15/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/22/2020
Last Recertification Date
2/27/2025
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
4140 N Broadway Street
Chicago, IL 60613
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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