OrganizationActive
Mile Square Davis/Brighton Park Satellite Health and Wellness Center
NPI 1497293344 · Federally Qualified Health Center (FQHC) · Chicago, IL
Provider details
- NPI number
- 1497293344
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- The Board of Trustees of the University of Illinois
- Organization subpart
- Yes
- Authorized official
- Henry Taylor, Executive Director(312) 412-1261
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3825 S Washtenaw Ave
Chicago, IL 60632-1633
Phone: (773) 376-5293
Street-level locationGet directions
Mailing address
3825 S Washtenaw Ave
Chicago, IL 60632-1633
Registry dates
- Enumerated
- 2017-02-10
- Last updated
- 2019-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.