| Winfield Moody Health Center | |
|
1276 N Clybourn Ave Chicago IL 60610-2089 | |
| (312) 337-1073 | |
| (312) 337-7616 |
| Full Name | Winfield Moody Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1276 N Clybourn Ave, Chicago, Illinois |
| Authorized Official Name and Position | Berneice Mills-thomas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3123371073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Winfield Moody Health Center 1276 N Clybourn Ave Chicago IL 60610-2089 Ph: (312) 337-1073 | Winfield Moody Health Center 1276 N Clybourn Ave Chicago IL 60610-2089 Ph: (312) 337-1073 |
| NPI Number | 1821079088 |
|---|---|
| Provider Enumeration Date | 11/07/2005 |
| Last Update Date | 07/26/2021 |
| Certification Date | 07/26/2021 |
| Medicare PECOS PAC ID | 9638165749 |
|---|---|
| Medicare Enrollment ID | O20040423000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821079088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| Provider Name | Sharon L Lieteau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427279777 PECOS PAC ID: 2668441957 Enrollment ID: I20041004000136 |
| Provider Name | Mary H Brow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619077559 PECOS PAC ID: 7810092558 Enrollment ID: I20070425000133 |
| Provider Name | Michael Durand Newkirk |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1669659751 PECOS PAC ID: 3678651643 Enrollment ID: I20080416000657 |
| Provider Name | Ashti a Doobay Persaud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407023799 PECOS PAC ID: 0648316232 Enrollment ID: I20091013000351 |
| Provider Name | Madhumita a Chatterjee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679510804 PECOS PAC ID: 4486681731 Enrollment ID: I20100304000905 |
| Provider Name | Paul J Bryar |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114986536 PECOS PAC ID: 1052448214 Enrollment ID: I20100420000179 |
| Provider Name | Nkeiruka O Dara |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679801476 PECOS PAC ID: 1951433739 Enrollment ID: I20100714000203 |
| Provider Name | Daniel P Vicencio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174508246 PECOS PAC ID: 6406049741 Enrollment ID: I20101019001589 |
| Provider Name | Wasiu Durojaiye |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871706556 PECOS PAC ID: 4688620198 Enrollment ID: I20140422001198 |
| Provider Name | Stephen a Watson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134452857 PECOS PAC ID: 6406070358 Enrollment ID: I20140616000340 |
| Provider Name | Rebecca Jehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235415597 PECOS PAC ID: 4880819234 Enrollment ID: I20140627001368 |
| Provider Name | Mary Barsanti-sekhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528285566 PECOS PAC ID: 9032334263 Enrollment ID: I20140702001025 |
| Provider Name | Christina T Soriano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215215744 PECOS PAC ID: 3678713799 Enrollment ID: I20140801000976 |
| Provider Name | Leah M Van Slambrouck |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699009654 PECOS PAC ID: 4486978327 Enrollment ID: I20150123000910 |
| Provider Name | Syeda Shariff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205935277 PECOS PAC ID: 6608191820 Enrollment ID: I20150211000739 |
| Provider Name | Hyo Youn Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588981138 PECOS PAC ID: 7315230356 Enrollment ID: I20160727003028 |
| Provider Name | Rukayatu Ibrahim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861803595 PECOS PAC ID: 1355637034 Enrollment ID: I20160906002011 |
| Provider Name | Emily Robertson-shelby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740641737 PECOS PAC ID: 6305125857 Enrollment ID: I20161128001173 |
| Provider Name | Danielle Babbington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801165758 PECOS PAC ID: 0648551143 Enrollment ID: I20161221000117 |
| Provider Name | Stephanie B Cox-batson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437242385 PECOS PAC ID: 1254311707 Enrollment ID: I20171004001169 |
| Provider Name | Elizabeth Herzan-taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336395078 PECOS PAC ID: 8325303266 Enrollment ID: I20180524002304 |
| Provider Name | Bonnie William Thomas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851321467 PECOS PAC ID: 2163603341 Enrollment ID: I20190522000568 |
| Provider Name | Johana B Gimenez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417478629 PECOS PAC ID: 8921343187 Enrollment ID: I20200520000040 |
| Provider Name | Judith Disterhoft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093154809 PECOS PAC ID: 4486932647 Enrollment ID: I20220405000484 |
| Provider Name | David Ramirez |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1003308297 PECOS PAC ID: 3173872611 Enrollment ID: I20231130000232 |
| Provider Name | Shea Welsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134483233 PECOS PAC ID: 1456581545 Enrollment ID: I20240213003213 |
| Provider Name | Laura Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750044194 PECOS PAC ID: 9335673789 Enrollment ID: I20241107004103 |
| Provider Name | Doris Chizoma Ihejieto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144984915 PECOS PAC ID: 2961927751 Enrollment ID: I20250414003365 |
| Provider Name | Richard M Reinhard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982606497 PECOS PAC ID: 7113161985 Enrollment ID: I20250620000281 |
| Provider Name | Nicholas Brent Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750162780 PECOS PAC ID: 3678086295 Enrollment ID: I20250627001300 |
| Provider Name | Jenny Hye Jin Cha-kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346258563 PECOS PAC ID: 8224541719 Enrollment ID: I20250627003136 |
| Provider Name | Loudjine Jean-michel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154729598 PECOS PAC ID: 1850804345 Enrollment ID: I20250627003163 |
| Provider Name | Taja Laniece Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962270207 PECOS PAC ID: 3779097308 Enrollment ID: I20250707003765 |
| Provider Name | Sydney M Junion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154186906 PECOS PAC ID: 3173037579 Enrollment ID: I20250708003574 |
| Provider Name | Kanako Morikawa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912782442 PECOS PAC ID: 2062927924 Enrollment ID: I20250711001039 |
| Provider Name | Danielle L Steker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215373865 PECOS PAC ID: 6204128960 Enrollment ID: I20250718003206 |
| Provider Name | Anana Adjoa Adila Upton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760256861 PECOS PAC ID: 6406362060 Enrollment ID: I20250721002702 |
| Provider Name | Rachel Melissa Gillett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487499612 PECOS PAC ID: 6305353905 Enrollment ID: I20250729001550 |
| Provider Name | Eva Astacio |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720849995 PECOS PAC ID: 3375041072 Enrollment ID: I20250812002377 |
| Provider Name | Alina M Catana Macovei |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1790125870 PECOS PAC ID: 0648779884 Enrollment ID: I20250815001564 |
| Provider Name | Lauren H. Le |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366637902 PECOS PAC ID: 9638670987 Enrollment ID: I20250828004030 |
| Provider Name | Aesha Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639546021 PECOS PAC ID: 7719294073 Enrollment ID: I20250911000951 |
| Provider Name | Jamilah Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538058110 PECOS PAC ID: 2567968654 Enrollment ID: I20250929001438 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 |
A Kavaliunas MD SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 |
Doc Cam Medical Center SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 |