GRAND PRAIRIE SERVICES (NPI# 1093870602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093870602 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
136 - 142 1 2 S. Clinton Bradley IL 60915 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 8159392313 |
| Practice Fax Number | 8159392835 |
| Mailing Telephone | 7086231511 |
| Mailing Fax Number | 7086149449 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | SHARRONNE WARD (PRESIDENT & CEO) |
| Authorized Official Telephone | 7084441012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154896371 | Grand Prairie Services | Clinic/Center | 747 Red Oak Ln, University Park, IL 60484-2965 | 2018-10-04 |
| 1053897736 | Grand Prairie Services | Clinic/Center | 759 Burr Oak Ln, University Park, IL 60484-2865 | 2018-07-16 |
| 1932526548 | Grand Prairie Services | Clinic/Center | 404 Sandburg St, Park Forest, IL 60466-1106 | 2014-03-20 |
| 1417132093 | Grand Prairie Services | Clinic/Center | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2008-01-02 |
| 1730363458 | Grand Prairie Services | Clinic/Center | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2007-12-18 |
| 1063576502 | Grand Prairie Services | Clinic/Center | 67 E 34th St, Steger, IL 60475-1106 | 2006-12-20 |
| 1578627014 | Grand Prairie Services | Clinic/Center | 202 Westwood Dr, Park Forest, IL 60466-1617 | 2006-12-20 |
| 1770647059 | Grand Prairie Services | Clinic/Center | 561 Saratoga Dr, Chicago Heights, IL 60411-1914 | 2006-12-20 |
| 1598829020 | Grand Prairie Services | Clinic/Center | 854 Burnham Ave, Calumet City, IL 60409-4539 | 2006-12-20 |
| 1093879371 | Grand Prairie Services | Clinic/Center | 1236 Ashland Ave, Chicago Heights, IL 60411-2544 | 2006-12-20 |
| Street Address |
136 - 142 1 2 S. CLINTON |
| City | BRADLEY |
| State | IL |
| Zip Code | 60915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1679826309 | Heather Sevier | Specialist/Technologist | 328 S Dearborn Ave, Bradley, IL 60915 | 2012-10-18 |
| 1013266584 | Arlene De Leon Delacruz | Physical Therapist | 400 South Kennedy Dr., Bradley, IL 60915 | 2012-08-30 |
| 1023370699 | Jessica Sorensen | Physician Assistant | 350 N Kinzie Ave, Bradley, IL 60915 | 2012-06-11 |
| 1184993164 | Debra Malone | Behavioral Analyst | 136-142 1/2 South Clinton, Bradley, IL 60915 | 2011-12-21 |
| 1376840421 | Joshua R Johnson | Physician Assistant | 400 S. Kennedy, Bradley, IL 60915 | 2011-02-24 |
| 1801192133 | Eloise Adams | Behavioral Analyst | 136 142 1/2 South Clinton, Bradley, IL 60915 | 2011-02-03 |
| 1386948685 | Rico J Hale | Behavioral Analyst | 136 142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1558665851 | Joyce A Bollhorst | Behavioral Analyst | 136-142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1538469655 | Kankakee Valley Chiropractic | Chiropractor | 300 North Kennedy Drive, Suite 2, Bradley, IL 60915 | 2010-10-22 |
| Find all providers in zip 60915 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568619799 | The Thresholds | Clinic/Center | 123 N West Ave, Bradley, IL 60915-1683 | 2008-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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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.