| Imani Community Clinic | |
|
502 W 138th St Riverdale IL 60827-1611 | |
| (312) 763-6162 | |
| Not Available |
| Full Name | Imani Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 502 W 138th St, Riverdale, Illinois |
| Authorized Official Name and Position | Janice Mwaniki (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3128237793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imani Community Clinic 502 W 138th St Riverdale IL 60827-1611 Ph: (312) 763-6162 | Imani Community Clinic 502 W 138th St Riverdale IL 60827-1611 Ph: (312) 763-6162 |
| NPI Number | 1053107813 |
|---|---|
| Provider Enumeration Date | 04/17/2025 |
| Last Update Date | 07/01/2026 |
| Certification Date | 07/01/2026 |
| Medicare PECOS PAC ID | 1759892581 |
|---|---|
| Medicare Enrollment ID | O20250618000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053107813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (NU) | Secondary |
| Provider Name | Joseph W Ofisi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295057610 PECOS PAC ID: 3375797830 Enrollment ID: I20130208000269 |
| Provider Name | Hala I Khalil |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144111675 PECOS PAC ID: 8527555259 Enrollment ID: I20251015003189 |
| Provider Name | Nicole Borissa Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255104337 PECOS PAC ID: 4183193311 Enrollment ID: I20260518002260 |
Aunt Martha's Youth Service Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14424 S Wentworth Ave, Riverdale, IL 60827 Phone: 708-747-7100 |
Sunrise Clinical Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W 138th Street, Riverdale, IL 60827 Phone: 312-778-4258 Fax: 708-880-1239 |