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URB162 AMERICAN INDIAN HEALTH SERVICE OF CHICAGO, INC. (Active)
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Main Details
Name
AMERICAN INDIAN HEALTH SERVICE OF CHICAGO, INC.
Subdivision Name
Type
Urban Indian
340B ID
URB162
Additional Details
Current Program Status
Active
Registration Date
7/1/2001
Participating Start Date
7/1/2001
Participating Approval Date
9/30/2004
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
American Indian Health Service of Chicago
Albert Mensah, Interim Executive Director/Medical Director
(773) 883-9100
Primary Contact
American Indian Health Service of Chicago
Melissa T Talavera, Executive Assistant
(773) 883-9100 Ext: 1002
Addresses
Street Address
4326 W. Montrose Ave
CHICAGO, IL 60641
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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ADMIN CORRECTION - REPLACES FQHC638186, NEW ADDRESS
09/30/2004
April 2025
April 2025
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