BOYS & GIRLS CLUB OF CHICAGO - ROBERT R. MCCORMICK BOYS & GIRLS CLUB (NPI# 1417134131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417134131 |
Entity Type | Organization |
Organization Name | BOYS & GIRLS CLUB OF CHICAGO - ROBERT R. MCCORMICK BOYS & GIRLS CLUB |
Practice Address |
4835 N Sheridan Rd Chicago IL 60640-3718 |
Practice Telephone | 7732718400 |
Practice Fax Number | 7732712425 |
Mailing Telephone | 7732718400 |
Mailing Fax Number | 7732712425 |
Enumeration Date | 2008-01-24 |
Last Update Date | 2008-01-24 |
Authorized Official Name | GEORGE COLONE (CLUB DIRECTOR) |
Authorized Official Telephone | 7732718400 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
IL | Dental Providers |
Street Address |
4835 N SHERIDAN RD |
City | CHICAGO |
State | IL |
Zip Code | 60640-3718 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538472477 | Brightsmiles Pediatric Dentistry | Dentist | 4835 N Sheridan Rd, Chicago, IL 60640-3718 | 2010-07-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
Find all providers in zip 60640 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
1811300437 | Michaella Radich Heitzler | Dentist | 1611 N. Wolcott Ave, Chicago, IL 60622 | 2014-06-11 |
1356768030 | Esther Levine Pincus | Dentist | Chicago Dental Professionals, 2340 North Clybourn Avenue, Chicago, IL 60614 | 2014-03-19 |
1316382187 | Serena Mitchual | Dentist | 801 S Paulina St Rm 256, Chicago, IL 60612-7210 | 2013-05-07 |
1962790428 | Megan Davenport | Dentist | 1611 N. Wolcott Ave., Chicago, IL 60622-1362 | 2011-07-19 |
1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
1013147024 | Yummy Dental | Dentist | 3500 N Lincoln Ave, Chicago, IL 60657-1104 | 2009-07-24 |
1659513950 | Melissa Marie Connell | Dentist | 1611 Wolcott Ave., Chicago, IL 60622 | 2009-04-01 |
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.