PROVISO FAMILY SERVICES (NPI# 1285880252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285880252 |
| Entity Type | Organization |
| Organization Name | PROVISO FAMILY SERVICES |
| Other Organization Name | RESURRECTION BEHAVIORAL HEALTH |
| Practice Address |
3 Erie Ct Oak Park IL 60302-2519 |
| Mailing Address |
1820 S 25th Ave Broadview IL 60155-2864 |
| Practice Telephone | 7086812324 |
| Practice Fax Number | 7083455496 |
| Mailing Telephone | 7083383806 |
| Mailing Fax Number | 7086811289 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |
| Authorized Official Name | MRS. KRISTIN KAMINSKI (MANAGER, GENERAL ACCOUNTING) |
| Authorized Official Telephone | 7083383806 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 1616027 | 01 |
| Other Name | Type Code |
|---|---|
| Resurrection Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134376403 | Proviso Family Services | Clinic/Center | 1225 W Lake St, Melrose Park, IL 60160-4039 | 2008-08-19 |
| 1588810550 | Proviso Family Services | Clinic/Center | 100 N River Rd, Des Plaines, IL 60016-1209 | 2008-08-11 |
| Street Address |
3 ERIE CT |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-2519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609876077 | Paula B Green | Emergency Medicine | 3 Erie Ct, Oak Park, IL 60302-2519 | 2005-07-28 |
| 1558987883 | Encore Anesthesia Group LLC | Nurse Anesthetist, Certified Registered | 3 Erie Ct, Oak Park, IL 60302-2519 | 2020-06-23 |
| 1003475294 | Karen Ann B Denkov | Nurse Practitioner | 3 Erie Ct, Oak Park, IL 60302-2519 | 2019-06-11 |
| 1962067165 | Alteon Health Illinois, Pllc | Emergency Medicine | 3 Erie Ct, Oak Park, IL 60302-2519 | 2019-05-03 |
| 1013477926 | Charles Kersten | Student in an Organized Health Care Education/Training Program | 3 Erie Ct, Oak Park, IL 60302-2519 | 2019-03-25 |
| 1003374141 | Allison Byrne | Student in an Organized Health Care Education/Training Program | 3 Erie Ct, Oak Park, IL 60302 | 2019-03-07 |
| 1740744895 | Pipeline - Lakefront Medical Associates, LLC | Clinic/Center | 3 Erie Ct, Oak Park, IL 60302-2519 | 2019-01-23 |
| 1932672391 | Pipeline - Lakefront Medical Associates, LLC | Clinic/Center | 3 Erie Ct, Oak Park, IL 60302-2519 | 2019-01-09 |
| 1255807277 | Pipeline-west Suburban Medical Center, LLC | Psychiatric Unit | 3 Erie Ct, Oak Park, IL 60302-2519 | 2018-10-17 |
| 1538635545 | Pipeline-west Suburban Medical Center, LLC | Skilled Nursing Facility | 3 Erie Ct, Oak Park, IL 60302-2519 | 2018-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| 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 |
|---|---|---|---|---|
| 1518588334 | Seasons Within LLC | Clinic/Center | 1515 N Harlem Ave Ste 301, Oak Park, IL 60302-1205 | 2020-05-04 |
| 1063981207 | Nia Integrative Healing | Clinic/Center | 1122 Westgate St Ste 201a, Oak Park, IL 60301-1170 | 2018-11-16 |
| 1194244400 | Kristin Burns Mind and Body | Clinic/Center | 715 Lake St Ste 703, Oak Park, IL 60301 | 2017-09-18 |
| 1497981559 | N.a. Levy Md & Assoc, Ltd | Clinic/Center | 1011 W. Lake Street, Suite 418, Oak Park, IL 60301 | 2009-06-03 |
| 1992767602 | Hephzibah Children's Association | Clinic/Center | 946 North Blvd, Oak Park, IL 60301-1205 | 2006-04-06 |
| 1538700273 | Empower Family Therapy, LLC. | Clinic/Center | 137 N Oak Park Ave Ste 123, Oak Park, IL 60301-1300 | 2019-10-03 |
| 1245748722 | Blackbird Behavioral Health, PC | Clinic/Center | 715 Lake St Ste 410, Oak Park, IL 60301-1413 | 2018-01-18 |
| 1740725217 | Wisdom for The Journey, LLC | Clinic/Center | 1010 Lake St, Suite 200/253, Oak Park, IL 60301-1147 | 2016-12-19 |
| 1881911543 | Hephzibah Children's Association | Clinic/Center | 1144 Lake St, 5th Floor, Oak Park, IL 60301-6705 | 2010-04-21 |
| 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.