POWER TEEN PROGRAM (NPI# 1134458466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134458466 |
| Entity Type | Organization |
| Organization Name | POWER TEEN PROGRAM |
| Practice Address |
300 N Central Ave Chicago IL 60644 |
| Mailing Address |
9336 Morgan Ave Evanston IL 60203-1418 |
| Practice Telephone | 3122611421 |
| Mailing Telephone | 3122611421 |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |
| Authorized Official Name | MS. GLENDA CUNNINGHAM (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3125213336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071002911 | IL | Behavioral Health & Social Service Providers |
| Street Address |
300 N CENTRAL AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535638 | Marta Yvonne Palmer | Technician | 5008 W Adams, Chicago, IL 60644 | 2019-09-04 |
| 1861056848 | B U I L D Incorporated | Social Worker | 5100 W Harrison St., Chicago, IL 60644 | 2019-04-25 |
| 1851806269 | Habilitative Systems, Inc. | Case Management | 4732 W Ohio St, Chicago, IL 60644 | 2017-12-07 |
| 1336408665 | Meghan Nancy Daw | Dietitian, Registered | 646 S Central Ave, Chicago, IL 60644 | 2012-05-07 |
| 1164790515 | Elizabeth Eleanor Reid-tate | Pharmacist | 5222 W. Madison Avenue, Chicago, IL 60644 | 2011-12-13 |
| 1417198342 | Betty Jean Lofton | Counselor | 5938 W. Midway Park, Chicago, IL 60644 | 2009-03-24 |
| 1881856094 | Sanjay M. Patel M.d. S.c. | Psychiatry & Neurology | 5730 W. Roosevelt Road, Chicago, IL 60644 | 2008-06-29 |
| 1639348691 | Ysl Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 5107-21 West Jackson Blvd, Chicago, IL 60644 | 2008-02-25 |
| 1073795845 | Maryanne Rakidzioski | Occupational Therapist | 5103 W Jackson Blvd, Chicago, IL 60644 | 2007-12-03 |
| 1427279777 | Sharon Lewis Lieteau | Psychiatry & Neurology | 415 South Kilpatrick Avenue, Chicago, IL 60644 | 2007-05-02 |
| Find all providers in zip 60644 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| 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.