Near North Health Serv Komed – Federally Qualified Health Center (FQHC), NPI 1346221553

Near North Health Serv Komed is a healthcare provider. based in Chicago, Illinois. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Near North Health Serv Komed is 1346221553

Main info

Organization
Name
Near North Health Serv Komed
NPI
1346221553
Phone
(773) 268-7600
Address
1276 N CLYBOURN AVE
Authorized Official
MRS. BERNEICE MILLS-THOMAS EXECUTIVE
Enumeration Date
7 November 2005
Last Update Date
21 July 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Near North Health Serv Komed

  • Winfield Moody Health Center, 1276, North Clybourn Avenue, Cabrini-Green, Chicago River North, Chicago, Cook County, Illinois, 60610, United States

    CHICAGO, IL 606102089

    Phone: (773) 268-7600

    Fax: (773) 268-9088

    Type: Mailing

  • 4259, South Berkeley Avenue, Oakland, Chicago, Hyde Park Township, Cook County, Illinois, 60653, United States

    CHICAGO, IL 606533030

    Phone: (773) 268-7600

    Fax: (773) 268-9088

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-04-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090423000498OFederally Qualified Health Center (Fqhc)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60610)

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Reviews

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Frequently asked questions

How do I look up Near North Health Serv Komed by NPI?
Use NPI 1346221553 when you need to reference Near North Health Serv Komed in forms, claims, or directories.
Is Near North Health Serv Komed active in the national directory?
Near North Health Serv Komed's public NPI profile is in an active state.
What does Near North Health Serv Komed treat or focus on?
Patients typically see Near North Health Serv Komed under the specialty Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Where does public data place Near North Health Serv Komed?
The snapshot lists Chicago, Illinois for Near North Health Serv Komed; download NPPES for the complete set.
How can I contact Near North Health Serv Komed?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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