PLACE OF RESTORATION (NPI# 1447584388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447584388 |
| Entity Type | Organization |
| Organization Name | PLACE OF RESTORATION |
| Other Organization Name | THE LORD'S TABLE |
| Practice Address |
4332 N Kedzie Ave 1st Floor Chicago IL 60618-1302 |
| Practice Telephone | 7732675008 |
| Mailing Telephone | 7732675008 |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |
| Authorized Official Name | MR. OLUMIDE OLUWOLE (DIRECTOR) |
| Authorized Official Telephone | 7733921585 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | THE LORD'S TABLE |
| 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 |
| Other Name | Type Code |
|---|---|
| THE LORD'S TABLE | Other Name - Individual/Organization |
| Street Address |
4332 N KEDZIE AVE 1ST FLOOR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60618-1302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741622 | Cvs Aoc Services, L.L.C. | Optometrist | 4051 North Lincoln, Store 8751, Chicago, IL 60618 | 2020-05-07 |
| 1699317404 | Joseph Thank Harmon | Registered Nurse | 5645 W Addison, Chicago, IL 60618 | 2019-10-14 |
| 1760952626 | Prep Performance Center, LLC | Clinic/Center | 4022 N Rockwell Street, Chicago, IL 60618 | 2018-12-04 |
| 1528540986 | Ruby Erdmann | Dietitian, Registered | 3126 N Kimball Ave. #3w, Chicago, IL 60618 | 2018-09-02 |
| 1962997064 | Living Roots Psychotherapy, LLC | Clinic/Center | 4310 N Spaulding Ave, Chicago, IL 60618 | 2018-06-30 |
| 1962920116 | Alif Muhammad | Counselor | 3819 W Cornelia Ave #2, Chicago, IL 60618 | 2017-09-07 |
| 1417471178 | Daniel Lee Mcmillan | Counselor | 3433 N. Ridgeway Ave, Apt G, Chicago, IL 60618 | 2017-08-03 |
| 1508380486 | Callie Weinberg | Social Worker | 2945 N Damen Ave, 1s, Chicago, IL 60618 | 2017-08-01 |
| 1275062697 | Melissa Ann Prest | Dietitian, Registered | 3258 W Warner Ave, Apt 2, Chicago, IL 60618 | 2017-06-08 |
| 1871951038 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 4315 N. Lincoln Avenue, Chicago, IL 60618 | 2016-02-03 |
| Find all providers in zip 60618 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1144837055 | Totality. Therapies LLC | Clinic/Center | 2027 W Division St Ste 157, Chicago, IL 60622-9024 | 2020-09-24 |
| 1790391373 | Luminary Solutions, LLC | Clinic/Center | 3166 N Lincoln Ave Ste 305, Chicago, IL 60657-3119 | 2020-09-19 |
| 1114533924 | A Safe Haven, L.L.C. | Clinic/Center | 600 S Wabash Ave, Chicago, IL 60605-1808 | 2020-09-17 |
| 1235745142 | A Safe Haven, L.L.C. | Clinic/Center | 7355 N Damen Ave, Chicago, IL 60645-2311 | 2020-09-17 |
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| 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.