RINCON FAMILY SERVICES (NPI# 1093164824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093164824 |
Entity Type | Organization |
Organization Name | RINCON FAMILY SERVICES |
Practice Address |
5453 W Diversey Ave Chicago IL 60639-1413 |
Mailing Address |
3710 N Kedzie Ave Chicago IL 60618-4504 |
Practice Telephone | 8882150513 |
Practice Fax Number | 7734173293 |
Mailing Telephone | 7735649070 |
Enumeration Date | 2016-06-13 |
Last Update Date | 2018-11-01 |
Authorized Official Name | EDDY BORRAYO (PRESIDENT/CEO) |
Authorized Official Telephone | 7735649070 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 0488 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982150017 | Rincon Family Services | Community/Behavioral Health | 6926 N Glenwood Ave, Chicago, IL 60626-3412 | 2016-08-29 |
1912311275 | Rincon Family Services | Community/Behavioral Health | 4720 N Sheridan Rd, Chicago, IL 60640-5022 | 2014-06-16 |
1104243823 | Rincon Family Services | Community/Behavioral Health | 3710 N Kedzie Ave, Chicago, IL 60618-4504 | 2014-03-19 |
1003232034 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2014-03-14 |
1427271568 | Rincon Family Services | Clinic/Center | 3809 W Grand Ave, Chicago, IL 60651 | 2007-04-10 |
1316497597 | Rincon Family Services | Community/Behavioral Health | 4720 N Sheridan Rd, Chicago, IL 60640-5022 | 2016-10-11 |
1740730456 | Rincon Family Services | Clinic/Center | 3942 W North Ave, Chicago, IL 60647-4639 | 2016-10-05 |
1265881098 | Rincon Family Services | Clinic/Center | 3710 N Kedzie Ave, Chicago, IL 60618-4504 | 2016-06-13 |
1558710384 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2016-06-13 |
1588013312 | Rincon Family Services | Clinic/Center | 3809 W Grand Ave, Chicago, IL 60651-2004 | 2016-06-13 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | RINCON FAMILY SERVICES | 3942 W. North Avenue, Chicago, IL 60647-4639 |
Street Address |
5453 W DIVERSEY AVE |
City | CHICAGO |
State | IL |
Zip Code | 60639-1413 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003232034 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2014-03-14 |
1760969588 | Stephanie Clark | Counselor | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2018-07-24 |
1558710384 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2016-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
1568012375 | Ellen E Cox | Physical Therapist | 4369 W Diversey Ave, Chicago, IL 60639 | 2019-09-13 |
1306379268 | Michael Duarte | Family Medicine | 4417 W Diversey Ave, Chicago, IL 60639 | 2017-04-07 |
1013464593 | Ismile Dental | Dentist | 4953 West Fullerton Ave, Chicago, IL 60639 | 2016-09-01 |
1952773566 | Flor Cortes | Pharmacist | 4626 W Diversey, Chicago, IL 60639 | 2015-10-22 |
1205178654 | The Head Injury Center for Prevention and Community | Case Management | 1732 N. Narragansett Ave, Chicago, IL 60639 | 2013-03-25 |
1013299262 | Aamer Arboleda | Pharmacist | 1606 N. Mobile Ave., Chicago, IL 60639 | 2011-09-14 |
1295037927 | Mary Veronica Galiotto | Pharmacist | 2920 N Narragansett, Chicago, IL 60639 | 2010-12-01 |
1295067478 | Galileo Optical Co. | Eyewear Supplier (Equipment, not the service) | 5759 W. Fullerton, Chicago, IL 60639 | 2010-02-12 |
1831424548 | Sonrisa Family Dental At The Hall, P.C. | Dentist | 4608 A & B West Diversey Avenue, Chicago, IL 60639 | 2009-10-14 |
Find all providers in zip 60639 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
1053957993 | Safer Foundation | Clinic/Center | 769 W Jackson, Unit G, Chicago, IL 60661 | 2019-11-26 |
1255977195 | Safer Foundation | Clinic/Center | 6352 W Grand Ave, Chicago, IL 60639-2650 | 2019-11-26 |
1063068492 | The Threshold | Clinic/Center | 3015 W Harrison St, Chicago, IL 60612 | 2019-08-12 |
1790338150 | Solleys House | Clinic/Center | 4163 S Archer Ave, Chicago, IL 60632-1870 | 2019-07-24 |
1366925489 | Lurie Children's Adolescent Substance Abuse and Prevention Progarm | Clinic/Center | 1440 N Dayton St, Chicago, IL 60642-2644 | 2018-09-13 |
1710482815 | Gateway Foundation, Inc. | Clinic/Center | 415 N Dearborn St Ste 510, Chicago, IL 60654-4626 | 2018-03-29 |
1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
1053836395 | Aunt Martha's Health and Wellness, Inc. | Clinic/Center | 5001 S Michigan Ave Ste B, Chicago, IL 60615-2112 | 2017-08-08 |
1437679255 | Sixto Garcia | Clinic/Center | 1100 W. Cermak Rd, Chicago, IL 60608 | 2017-06-22 |
Find all providers in CHICAGO |
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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.