MRS. MICHELLE ELIZABETH CHURCHEY-MIMS (NPI# 1295859577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295859577 |
| Entity Type | Individual |
| Full Name | MRS. MICHELLE ELIZABETH CHURCHEY-MIMS |
| Credential | MA |
| Practice Address |
13136 Western Ave Blue Island IL 60406-2423 |
| Mailing Address |
2424 Lewis St Blue Island IL 60406-1717 |
| Practice Telephone | 7089745856 |
| Practice Fax Number | 3128290710 |
| Mailing Telephone | 7083852079 |
| Mailing Fax Number | 3128290710 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| Street Address |
13136 WESTERN AVE |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406-2423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659916724 | Meghan Kelly | Social Worker | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-11-13 |
| 1396302881 | Carolyn Barnes | Case Manager/Care Coordinator | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-21 |
| 1003473505 | Belinda Childs | Case Manager/Care Coordinator | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-21 |
| 1831756329 | James Branch | Case Manager/Care Coordinator | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-21 |
| 1619534203 | Candace Clark | Social Worker | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-20 |
| 1568920833 | Kimberley Jane Tarcak | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-03-06 |
| 1902371461 | Rachel Parker | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2018-10-10 |
| 1013408103 | Briana E Wright | Social Worker | 13136 Western Ave, Blue Island, IL 60406-2423 | 2018-05-23 |
| 1114420759 | Andrea R. Boyd | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2018-03-09 |
| 1578064036 | Sierra L Parham-gantt | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2018-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205708 | Cook County | Family Medicine | 12757 S. Western Ave, Blue Island, IL 60406 | 2020-04-30 |
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558640169 | Sandra Cecilia Knox | Counselor | 1715 Vermont St, Blue Island, IL 60406-2714 | 2011-08-12 |
| 1982889960 | Barbara Jean Massette | Counselor | 12641 Vincennes Rd, Blue Island, IL 60406-1609 | 2008-01-08 |
| 1609965623 | Janet Lou Biscan | Counselor | 13136 South Western Avenue, Blue Island, IL 60406 | 2006-10-11 |
| 1700973377 | Ascend | Counselor | 12641 S Vincennes Rd, Blue Island, IL 60406 | 2006-10-06 |
| 1245793066 | Sara Vicente Loredo | Counselor | 12145 Western Ave, Blue Island, IL 60406-1387 | 2019-04-09 |
| 1972954881 | Chantae Griffin | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2016-06-22 |
| 1285033274 | Jaime Chavez | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2014-08-15 |
| 1932538261 | Megan Rose Johnson | Counselor | 12145 Western Ave, Blue Island, IL 60406-1387 | 2013-11-07 |
| 1205269057 | John Peter Muckian Jr. | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2013-08-15 |
| 1629374202 | Jonathan Cavanaugh | Counselor | 12145 Western Ave, Blue Island, IL 60406-1387 | 2011-01-31 |
| Find all providers in BLUE ISLAND | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
Please comment or provide details below to improve the information on MRS. MICHELLE ELIZABETH CHURCHEY-MIMS.
| 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.