CORETTA J PRUITT (NPI# 1043778004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043778004 |
| Entity Type | Individual |
| Full Name | CORETTA J PRUITT |
| Practice Address |
641 W 63rd St Chicago IL 60621-2032 |
| Practice Telephone | 2245317966 |
| Practice Fax Number | 3123551110 |
| Mailing Telephone | 2245317966 |
| Mailing Fax Number | 3123551110 |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
641 W 63RD ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60621-2032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871595256 | City of Chicago | Clinic/Center | 641 W 63rd St, Chicago, IL 60621-2032 | 2005-08-15 |
| 1215553557 | Coketha Samyra Jean Hendricks | Social Worker | 641 W 63rd St, Chicago, IL 60621-2032 | 2020-06-23 |
| 1508425083 | Nakia Monique Campbell | Nurse Practitioner | 641 W 63rd St, Chicago, IL 60621-2032 | 2019-06-10 |
| 1548728686 | Kyndria Tisdale | Counselor | 641 W 63rd St, Chicago, IL 60621-2032 | 2019-03-07 |
| 1558837922 | Board of Trustees of The University of Illinois | Case Management | 641 W 63rd St, Chicago, IL 60621-2032 | 2018-10-23 |
| 1386126159 | Britt Elizabeth Hodgdon | Social Worker | 641 W 63rd St, Chicago, IL 60621-2032 | 2018-08-29 |
| 1750889945 | Kenya Spann | Counselor | 641 W 63rd St, Chicago, IL 60621-2032 | 2018-01-23 |
| 1447770060 | Caitlin Grace Williams | Psychologist | 641 W 63rd St, Chicago, IL 60621-2032 | 2017-06-24 |
| 1306292271 | Winnie Lin | Pediatrics | 641 W 63rd St, Chicago, IL 60621-2032 | 2016-05-10 |
| 1255791331 | Howard Brown Health Center | Clinic/Center | 641 W 63rd St, Chicago, IL 60621-2032 | 2016-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803394 | Conrad Care Incorporated | Home Health | 142 W . 62nd Street, Suite 203, Chicago, IL 60621 | 2020-05-18 |
| 1275068876 | St. Bernard Hospital Ambulatory Care Clinic | Clinic/Center | 6307 S Stewart, Chicago, IL 60621 | 2017-04-21 |
| 1063954519 | Created2careltd | Secured Medical Transport (VAN) | 5632 S. Emerald Ave, Chicago, IL 60621 | 2016-11-15 |
| 1932566023 | Windycitywheelchairservice | Technician, Other | 6427 S Parnell Ave, Chicago, IL 60621 | 2016-01-21 |
| 1194127787 | Aaa-1 Transportation | Secured Medical Transport (VAN) | 5740 S Emerald Ave, Chicago, IL 60621 | 2014-09-25 |
| 1871893859 | Anuj Jain | Family Medicine | 6508 S Halsted Street, Chicago, IL 60621 | 2010-10-25 |
| 1750538104 | Adolfo M. Maglaya, M.d., S.c. | Internal Medicine | 326 W. 64th St., Chicago, IL 60621 | 2008-08-27 |
| 1083882997 | Englewood Satellite Senior Center | Clinic/Center | 657 W. 63rd St, Chicago, IL 60621 | 2008-02-13 |
| 1295952059 | Carrington Radiology, S.c. | Radiology | St. Bernard Hospital, 326 W. 64th Street, 2nd Floor (radiology Department), Chicago, IL 60621 | 2007-04-20 |
| 1851427660 | Dilipkumar Parikh Md | Internal Medicine | 324 West 64th St, Suite 216, Chicago, IL 60621 | 2007-02-26 |
| Find all providers in zip 60621 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740887157 | Forefront Healthcare Solutions, Inc. | Case Manager/Care Coordinator | 60 E Monroe St Unit 3801, Chicago, IL 60603-2751 | 2020-10-08 |
| 1205441698 | Desirae Mccrainey | Case Manager/Care Coordinator | 55 E Monroe St Ste 38109, Chicago, IL 60603-5713 | 2020-09-11 |
| 1659993954 | Aubrey Williams | Case Manager/Care Coordinator | 1533 W Warren Blvd, Chicago, IL 60607-1852 | 2020-05-11 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1235772864 | Rebekah Johnson | Case Manager/Care Coordinator | 208 E 87th St, Chicago, IL 60619-6040 | 2019-10-27 |
| 1619447497 | Bria Stanciel | Case Manager/Care Coordinator | 8419 S Cottage Grove, Chicago, IL 60619 | 2018-12-05 |
| 1518442326 | Jeanta Barnes | Case Manager/Care Coordinator | 8058 S Yates Blvd, Chicago, IL 60617-1103 | 2018-09-27 |
| 1407333685 | 4d Healthware, LLC | Case Manager/Care Coordinator | 401 N Michigan Ave Ste 1740, Chicago, IL 60611-4742 | 2018-07-20 |
| 1174018774 | July Miranda | Case Manager/Care Coordinator | 2309 W 19th St, Chicago, IL 60608-2512 | 2018-06-26 |
| 1578063285 | Nisha Naiknimbalkar | Case Manager/Care Coordinator | 4127 S Drexel Blvd Apt 2s, Chicago, IL 60653-2865 | 2018-02-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.