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NEAR NORTH HEALTH
NPI 1821630054
Dental Hygienist in Chicago, IL

Active since October 09, 2019CLIA 14D2253837 · Waiver
4259 S BERKELEY AVE, CHICAGO, IL 60653(773) 629-5488 Get Directions Write a Review

NPPES record last updated: October 9, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Near North Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEAR NORTH HEALTH (NPI 1821630054) is a healthcare organization registered as a dental hygienist in Chicago, Illinois and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through February 23, 2028 and lists Destenii Thomas Anderson, Dental Hygienist, as its authorized official.

NPPES Registry Identity

NPI1821630054
Entity TypeOrganization
Primary Taxonomy124Q00000X
Legal Business NameNEAR NORTH HEALTH
Location Address4259 S BERKELEY AVEChicago, IL 60653-3030
Mailing Address4259 S Berkeley AveChicago, IL 60653-3030 · (773) 629-5488
Phone(773) 629-5488
Organization SubpartNo
Authorized OfficialDestenii Thomas AndersonDental Hygienist · (773) 629-5488
Enumeration DateOctober 9, 2019
✔ NPI 1821630054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental HygienistDental Providers
Taxonomy Code124Q00000X
Definition
An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.
4259 S BERKELEY AVE, Chicago, IL 60653
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2253837

Near North Health - Oakwood Shores Health Center · Chicago, IL
Active · expires Feb 23, 2028
CLIA Number14D2253837
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorJudith Opena Disterhoft
Laboratory Phone(312) 337-1073
Laboratory LocationNear North Health - Oakwood Shores Health Center3753 S Cottage Grove Ave, Chicago, IL 60653
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADEWALE OLAILAN LAWAL DMD
Dentist (General Practice)
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (312) 646-6620
MIGUEL BAUTISTA CADC
Counselor (Addiction (Substance Use Disorder))
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (773) 268-7600
NEAR NORTH HEALTH SERVICE CORPORATION
Clinic/Center (Federally Qualified Health Center (FQHC))
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (773) 268-7600
JENNY HYE JIN CHA-KIM M.D.
Pediatrics
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (773) 268-7600
DR. GREGORY C. VACHON M.D.
Internal Medicine
4259 S BERKELEY AVE, KOMED HEALTH CENTER
CHICAGO, IL 60653
Cook County (312) 285-7678
SAMANTHA KUFTA D.M.D
Dentist (Dental Public Health)
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (630) 965-7306
MRS. MARY CAITLIN GONDEK APN
Nurse Practitioner (Family)
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (773) 268-7600
KAYLA MARCHELLE JONES APN
Nurse Practitioner (Family)
4259 S BERKELEY AVE
CHICAGO, IL 60653
Cook County (773) 268-7600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Near North Health's NPI number?

The NPI number for Near North Health is 1821630054. It was assigned to this organization in the NPPES registry on October 9, 2019.

Where is Near North Health located?

Near North Health is located at 4259 S Berkeley Ave, Chicago, IL 60653. The listed phone number is (773) 629-5488.

What is Near North Health's specialty?

The primary specialty registered for this NPI is Dental Hygienist with taxonomy code 124Q00000X.

Does Near North Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2253837) is associated with this NPI, valid through February 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Near North Health was last updated on October 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.