PROVISO FAMILY SERVICES (NPI# 1588810550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588810550 |
| Entity Type | Organization |
| Organization Name | PROVISO FAMILY SERVICES |
| Other Organization Name | RESURRECTION BEHAVIORAL HEALTH |
| Practice Address |
100 N River Rd Des Plaines IL 60016-1209 |
| Mailing Address |
1820 S 25th Ave Broadview IL 60155-2864 |
| Practice Telephone | 7083383806 |
| Practice Fax Number | 7086811289 |
| Mailing Telephone | 7083383806 |
| Mailing Fax Number | 7086811289 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |
| Authorized Official Name | MRS. KRISTIN KAMISKI (MANAGER, GENERAL ACCOUNTING) |
| Authorized Official Telephone | 7083383806 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 1616027 | 01 |
| Other Name | Type Code |
|---|---|
| Resurrection Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134376403 | Proviso Family Services | Clinic/Center | 1225 W Lake St, Melrose Park, IL 60160-4039 | 2008-08-19 |
| 1285880252 | Proviso Family Services | Clinic/Center | 3 Erie Ct, Oak Park, IL 60302-2519 | 2008-08-11 |
| Street Address |
100 N RIVER RD |
| City | DES PLAINES |
| State | IL |
| Zip Code | 60016-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548364037 | Chandra B Reddy | Anesthesiology | 100 N River Rd, Des Plaines, IL 60016-1209 | 2006-09-12 |
| 1609415587 | Timothy David Nolan | Occupational Therapist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2019-12-24 |
| 1649683533 | Continental Anesthesia Holdings LLC | Anesthesiology | 100 N River Rd, Des Plaines, IL 60016-1209 | 2014-06-09 |
| 1669711933 | Lyju Lukose | Physical Therapist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2013-02-06 |
| 1821334442 | Christine Krill | Occupational Therapist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-12-31 |
| 1609111632 | Diane Ratto | Physical Therapist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-12-03 |
| 1265781165 | Lisa Jan Levy | Speech-Language Pathologist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-09-06 |
| 1245587765 | Zakaria Mohd Wahbi Almuwaqqat | Hospitalist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-08-15 |
| 1629325006 | Christie Stocking | Occupational Therapist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-08-06 |
| 1518214840 | Teresa Rao | Speech-Language Pathologist | 100 N River Rd, Des Plaines, IL 60016-1209 | 2012-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1407367022 | Vcare Pharmacy Inc | Pharmacy | 380 E Nortwest Hwy, Suite 201, Des Plaines, IL 60016 | 2017-10-23 |
| 1649799610 | George N Hotousiotis | Pharmacist | 10 East Golf Road, Des Plaines, IL 60016 | 2017-09-11 |
| 1619494838 | Abdul M Shamsuddin | Physical Therapist | 2555 Suffield St, Des Plaines, IL 60016 | 2017-08-28 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1902250178 | Perfect Storm Chiropractic, LLC | Chiropractor | 565 Concord Ln, Des Plaines, IL 60016 | 2016-04-14 |
| 1255796611 | Nektaria Goudis | Psychologist | 950 Lee Street, Des Plaines, IL 60016 | 2015-12-29 |
| 1831501352 | Gary R. Kuntz | Dentist | 1173 Algonquin Rd., Des Plaines, IL 60016 | 2014-06-02 |
| 1558773754 | Midwest Anesthesia and Pain Specialists, Sc | Pain Medicine | 9700 Golf Rd, Second Floor, Des Plaines, IL 60016 | 2014-05-22 |
| 1508282377 | Maciej Padowski | Emergency Medicine | 9500 Greenwood Dr, Des Plaines, IL 60016 | 2014-03-17 |
| Find all providers in zip 60016 | ||||
| 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 |
|---|---|---|---|---|
| 1902308497 | Gonzalez Clinical Therapy LLC | Clinic/Center | 1400 E Touhy Avenue Suite 240, Des Plaines, IL 60018 | 2018-03-01 |
| 1114434305 | Wild Indigo Counseling, LLC | Clinic/Center | 1363 S Wolf Rd, Des Plaines, IL 60018-1302 | 2018-01-09 |
| 1497924120 | Trinity Services Inc. | Clinic/Center | 2101 Oxford Rd., Des Plaines, IL 60018-1919 | 2008-02-27 |
| 1861901043 | Rosecrance Inc. | Clinic/Center | 701 Lee St, Des Plaines, IL 60016-4539 | 2017-09-20 |
| 1609223957 | Family Guidance Centers, Inc. | Clinic/Center | 484 Lee St, Des Plaines, IL 60016-4610 | 2016-05-17 |
| 1104146760 | Trinity Services Inc. | Clinic/Center | 2101 Oxford Rd, Des Plaines, IL 60018-1919 | 2010-06-07 |
| 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 | DES PLAINES |
| Zip Code | 60016 |
Please comment or provide details below to improve the information on PROVISO FAMILY SERVICES.
| 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.