CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO (NPI# 1295154813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295154813 |
Entity Type | Organization |
Organization Name | CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO |
Other Organization Name | LAKE COUNTY BEHAVIORAL HEALTH SERVICES |
Practice Address |
671 S Lewis Ave Waukegan IL 60085-6101 |
Practice Telephone | 8477824154 |
Practice Fax Number | 8477821030 |
Mailing Telephone | 8477824154 |
Mailing Fax Number | 8477821030 |
Enumeration Date | 2014-04-10 |
Last Update Date | 2018-04-04 |
Authorized Official Name | MICHAEL M BOLAND (ADMINISTRATOR, PRESIDENT AND CEO) |
Authorized Official Telephone | 3126557320 |
Authorized Official Credential | MSW |
Is Organization Subpart | Y |
Parent Organization Name | CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
N | 251B00000X | Case Management | Agencies | ||
N | 251E00000X | Home Health | Agencies | ||
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
04019 | IL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 04019 | 05 |
Other Name | Type Code |
---|---|
Lake County Behavioral Health Services | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922643055 | Catholic Charities of The Archdiocese of Chicago | Clinic/Center | 3019 W Harrison St, Chicago, IL 60612-3342 | 2019-11-13 |
1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
1881081263 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 1400 S Austin Blvd, Cicero, IL 60804-1003 | 2015-04-23 |
1003217506 | Catholic Charities of The Archdiocese of Chicago | Case Management | 1800 N Hermitage Ave, Chicago, IL 60622-1161 | 2014-09-16 |
1215282926 | Catholic Charities of The Archdiocese of Chicago | Case Management | 721 N Lasalle St, 5th Floor, Chicago, IL 60610 | 2012-07-18 |
1245564640 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 641 W Lake St, Chicago, IL 60661-1007 | 2009-10-01 |
1881928398 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 11255 S Michigan Ave, Chicago, IL 60628-4909 | 2009-09-30 |
1295854446 | Catholic Charities of The Archdiocese of Chicago | Clinic/Center | 721 N La Salle Dr, Chicago, IL 60654-3751 | 2007-03-28 |
1407971211 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 1100 S May St, Fl 2, Chicago, IL 60607-4229 | 2007-03-20 |
1629130083 | Catholic Charities of The Archdiocese of Chicago | Case Management | 116 Lincoln Ave, Round Lake, IL 60073-5009 | 2006-12-14 |
Street Address |
671 S LEWIS AVE |
City | WAUKEGAN |
State | IL |
Zip Code | 60085-6101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669071833 | Erica Slattery | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-10-20 |
1073124269 | Erika Denny | Social Worker | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-08-12 |
1457962615 | Samantha Tomasello | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-08-12 |
1558972836 | Dawid Tryba | Social Worker | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-08-11 |
1962026971 | Jennifer Rae Flanagan | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-06-04 |
1417587544 | Kaitlynn Elizabeth Martin | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2020-01-16 |
1336798636 | Marilyn Hernandez | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2019-09-09 |
1528615366 | Jackie Machamer | Student in an Organized Health Care Education/Training Program | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2019-08-26 |
1245883727 | Janeth Brindis | Social Worker | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2019-07-23 |
1174176663 | Chakeysha Jasmine Mckinney-lyons | Counselor | 671 S Lewis Ave, Waukegan, IL 60085-6101 | 2019-07-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
Find all providers in zip 60085 |
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 |
---|---|---|---|---|
1649806407 | The Josselyn Center Nfp | Clinic/Center | 415 Washington St Ste 200, Waukegan, IL 60085-5564 | 2020-03-12 |
1588297980 | Little City Foundation | Clinic/Center | 1301 S Lewis Ave, Waukegan, IL 60085-7814 | 2020-02-14 |
1811109184 | County of Lake | Clinic/Center | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2007-05-07 |
1700336229 | Nicasa, Nfp | Clinic/Center | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2016-10-07 |
1164446712 | County of Lake | Clinic/Center | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2006-07-27 |
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 |
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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.