DIVINE INTERVENTION HEALTHCARE, INC (NPI# 1427302041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427302041 |
| Entity Type | Organization |
| Organization Name | DIVINE INTERVENTION HEALTHCARE, INC |
| Practice Address |
4747 Lincoln Mall Dr Suite 502 Matteson IL 60443-3811 |
| Practice Telephone | 7082487662 |
| Practice Fax Number | 7082487682 |
| Mailing Telephone | 7082487662 |
| Mailing Fax Number | 7082487682 |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |
| Authorized Official Name | MRS. SANDRENA A HARRIS (DIRECTOR OF NURSING) |
| Authorized Official Telephone | 7082487662 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 2003090 | IL | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093042863 | Divine Intervention Healthcare, Inc | Non-emergency Medical Transport (VAN) | 2158 45th St Ste 303, Highland, IN 46322-3742 | 2009-11-15 |
| 1912292806 | Divine Intervention Healthcare, Inc | Home Infusion | 4747 Lincoln Mall Dr, Suite 502, Matteson, IL 60443-3811 | 2011-06-19 |
| Street Address |
4747 LINCOLN MALL DR SUITE 502 |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790795805 | Bnm Professional Consulting Services, Inc. | Physical Therapist | 4747 Lincoln Mall Dr, Suite #302, Matteson, IL 60443-3811 | 2006-08-09 |
| 1669012910 | Olufemi Matimoju | Social Worker | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2020-01-14 |
| 1285277905 | Shaneika Tolliver | Social Worker | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2019-10-25 |
| 1013574458 | Angela Maria Cunningham | Social Worker | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2019-05-21 |
| 1356801856 | Patricia Ann Willis | Counselor | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2019-03-21 |
| 1366901290 | Amanda Briick | Counselor | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2019-03-19 |
| 1790239291 | Ollie Owens | Counselor | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2016-08-12 |
| 1518411016 | Brittany Lampkin | Counselor | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2016-08-12 |
| 1255885752 | Shanna Walker | Counselor | 4747 Lincoln Mall Dr, 601, Matteson, IL 60443-3811 | 2016-08-12 |
| 1386028835 | The Dubois Douglas Centres | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4747 Lincoln Mall Dr, Suite 301, Matteson, IL 60443-3811 | 2015-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
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| 1407467509 | Shiloh Hospice & Palliative Care, LLC | Hospice Care, Community Based | 603 E 170th St, South Holland, IL 60473-3408 | 2020-08-12 |
| 1649892126 | Vital Care Hospice, LLC | Hospice Care, Community Based | 1400 Torrence Ave Ste 205, Calumet City, IL 60409-5550 | 2020-05-07 |
| 1174144463 | Five Star Hospice and Palliative Care LLC | Hospice Care, Community Based | 2500 W Higgins Rd Ste 1277, Hoffman Estates, IL 60169-2051 | 2020-04-28 |
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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.