| SHAPE |
Point |
| HCC_FCT_ID |
18912 |
| SITE_SOURCE_ID |
CCCC7B17-3DD5-426D-AB96-FF3CC94EE88B |
| SITE_NM |
Komed Holman Health Center |
| UDS_NUM |
05328B |
| SITE_PHONE_NUM |
773-268-7600 |
| SITE_URL |
www.nearnorthhealth.org |
| TOT_OPER_HR_PER_WEEK |
44 |
| HCC_GRANTEE_ID |
|
| GRANTEE_SOURCE_ID |
7E667654-B758-420E-BF33-0D3C9955B2AA |
| GRANT_NUM |
H80CS00194 |
| GRANTEE_NM |
THE NEAR NORTH HEALTH SERVICE CORPORATION |
| GRANTEE_ORG_DESC |
Corporate Entity, Federal Tax Exempt |
| MHC_SUB_PROG_IND |
N |
| CH_SUB_PROG_IND |
N |
| SBHC_SUB_PROG_IND |
N |
| PHPC_SUB_PROG_IND |
N |
| HCH_SUB_PROG_IND |
N |
| SITE_ADDRESS_ID |
5880 |
| SITE_ADDRESS_SOURCE_ID |
4335239C-3986-4F76-A1DC-4E95E1F4D49B |
| SITE_ESR_SOURCE_ID |
43A2056A-4022-4DF8-A8A4-353B111D18B6 |
| SITE_DATA_SOURCE |
ESR_SCP |
| SITE_ADDRESS |
4259 S Berkeley Ave |
| SITE_CITY |
Chicago |
| SITE_STATE_ABBR |
IL |
| SITE_ZIP_CD |
60653-3030 |
| US_MEXICO_BORDER_100KM_IND |
N |
| SITE_POP_TYP_DESC |
Urban |
| HCC_LOC_SETTING_ID |
7 |
| HCC_LOC_SETTING_DESC |
All Other Clinic Types |
| HCC_STATUS_ID |
1 |
| HCC_STATUS_DESC |
Active |
| HCC_LOC_ID |
1 |
| HCC_LOC_DESC |
Permanent |
| HCC_TYP_ID |
2 |
| HCC_TYP_DESC |
Service Delivery Site |
| HCC_OPER_ID |
1 |
| HCC_OPER_DESC |
Health Center/Applicant |
| HCC_OPER_SCHD_ID |
1 |
| HCC_OPER_SCHD_DESC |
Full-Time |
| HCC_CLND_SCHD_ID |
1 |
| HCC_CLND_SCHD_DIM_DESC |
Year-Round |
| COUNTY_FIPS_CD |
031 |
| COUNTY_NM |
Cook |
| COUNTY_DESC |
County |
| LIST_BOX_COUNTY_NM |
Cook County |
| STATE_COUNTY_FIPS_CD |
17031 |
| STATE_FIPS_CD |
17 |
| STATE_NM |
Illinois |
| US_SENATE_NM1 |
Richard J. Durbin |
| US_SENATE_NM2 |
Tammy Duckworth |
| REGION_CD |
05 |
| REGION_NM |
Region 5 |
| US_MEXICO_BORDER_COUNTY_IND |
N |
| CONG_DIST_NUM |
01 |
| CONG_DIST_NM |
Illinois District 01 |
| STATE_FIPS_CD_CONG_DIST_NUM |
1701 |
| REPRESENTATIVE_NM |
Jonathan L. Jackson |
| REPRESENTATIVE_URL |
https://jonathanjackson.house.gov |
| BPHC_SITE_NUM |
BPS-H80-005641 |
| BHCMISID |
|
| FQHC_LAL_NUM |
|
| FQHC_ORG_NM |
|
| FQHC_ADDRESS |
|
| FQHC_CITY |
|
| FQHC_STATE_ABBR |
|
| FQHC_ZIP_CD |
|
| FQHC_ADMIN_CONTACT_NM |
|
| FQHC_ADMIN_CONTACT_PHONE_NUM |
|
| FQHC_ADMIN_CONTACT_EMAIL |
|
| RURAL_IND |
N |
| GRANT_SOURCE_ID |
0A60A857-FEF9-43DD-A829-392C4885583E |
| ADMIN_PHONE_NUM |
|
| SITE_FAX_NUM |
|
| REGION_ID |
5 |
| STATE_ID |
14 |
| COUNTY_ID |
611 |
| CONG_DIST_ID |
9040 |
| CMN_REGION_CD |
05 |
| CMN_REGION_NM |
Region 5 |
| CMN_STATE_NM |
Illinois |
| CMN_STATE_ABBR |
IL |
| CMN_STATE_FIPS_CD |
17 |
| CMN_STATE_COUNTY_FIPS_CD |
17031 |
| CMN_COUNTY_NM_STATE_ABBR |
Cook County, IL |
| CMN_CONG_NUM |
119 |
| CMN_STATE_FIPS_CONG_DIST_NUM |
1701 |
| CMN_CONG_DIST_NM |
Illinois District 01 |
| CMN_ZIP_CD |
60653 |
| CMN_CITY_NUM |
Chicago, IL |
| LOC_NAME |
01-ESRI,SO |
| SCORE |
100 |
| APPROX_VALUE_CD |
N |
| LOC_NAME_DESC |
Data was matched at the Address level using AGOL, and Service Objects |
| HCP_COVID19_TEST_CAP_STATUS |
Yes |
| HCP_COVID19_DU_TEST_CAP_STATUS |
No |
| HCP_COVID19_TELE_CAP_STATUS |
Yes |
| HCP_COVID19_TEST_CAP |
As of 05/28/2021, this health center reported providing COVID-19 testing at one or more sites. Please call the center for more information. |
| HCP_COVID19_TELEHEALTH_CAP_TXT |
As of 05/28/2021, this health center reported providing COVID-19 testing and services via telehealth at one or more sites. Please call the center for more information. |