GRAND PRAIRIE SERVICES (NPI# 1346304979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346304979 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7084441012 |
| Practice Fax Number | 7086149449 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086149449 |
| Enumeration Date | 2006-12-20 |
| 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 |
| 1093870602 | Grand Prairie Services | Clinic/Center | 136 - 142 1 2 S. Clinton, Bradley, IL 60915 | 2006-12-26 |
| 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 |
| Street Address |
17746 OAK PARK AVE |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60477-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407464860 | Brian Williams | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2020-07-21 |
| 1073157939 | Ryan Thomas | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| 1154965010 | Fred Groves | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| 1831742345 | Naisa Holmes | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-07-23 |
| 1801454699 | Patricia Young | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-06-05 |
| 1265994735 | Keisha Kimble | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-04-03 |
| 1740747567 | Pleashette Pinkston | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-02-28 |
| 1386100568 | Renee Watson | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-02-13 |
| 1134693070 | Levon Davis | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-01-14 |
| 1740764414 | Sharron Hannah | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2018-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522366 | Joshua Gruenke | Physical Therapist | 17129 S. Harlem Avenue, Tinley Park, IL 60477 | 2020-09-14 |
| 1881229656 | Sherrie Lynn Tsang | Massage Therapist | 7925 West 171st Street, Tinley Park, IL 60477 | 2020-03-11 |
| 1437782117 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 17129 S Harlem Ave. Ste B3, Tinley Park, IL 60477 | 2020-02-20 |
| 1356998561 | Rasa Vaskeviciute | Physical Therapist | 17129 So Harlem, Tinley Park, IL 60477 | 2019-08-22 |
| 1538728258 | Michelle Anne Wisen | Physical Therapy Assistant | 17129 South Harlem, Suite B3, Tinley Park, IL 60477 | 2019-06-06 |
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1316445794 | Yvonne Tran | Physical Therapist | 17129 S Harlem Ave, Tinley Park, IL 60477 | 2018-01-31 |
| 1326574591 | Nicholas Barker | Chronic Disease Hospital | 7859 Joliet Drive North, Tinley Park, IL 60477 | 2017-05-10 |
| 1982063632 | Nicole Kristine Demarco | Specialist/Technologist | 16317 Clark Ln, Tinley Park, IL 60477 | 2016-02-22 |
| 1376900571 | Ucp Seguin Greater Chicago | Foster Care Agency | 7550 W. 183rd, Tinley Park, IL 60477 | 2016-01-20 |
| Find all providers in zip 60477 | ||||
| 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 |
|---|---|---|---|---|
| 1629514120 | David Kushner Do PC | Clinic/Center | 8041 186th St, Suite B, Tinley Park, IL 60487-9343 | 2017-01-09 |
| 1093884587 | Professional Counseling Services Ltd | Clinic/Center | 17732 Oak Park Avenue, Tinley Park, IL 60477 | 2006-11-07 |
| 1619100831 | The Office of Adele M. Bryant, LLC | Clinic/Center | 17127 Oak Park Ave, Tinley Park, IL 60477-3405 | 2009-09-04 |
| 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 | ||||
| City | TINLEY PARK |
| Zip Code | 60477 |
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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.