GRAND PRAIRIE SERVICES (NPI# 1639233174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639233174 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
21136 Keeler Ave Matteson IL 60443-2242 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7084811360 |
| Practice Fax Number | 7084819442 |
| 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 |
21136 KEELER AVE |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-2242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467968750 | Tamela S Jasper | Counselor | 21136 Keeler Ave, Matteson, IL 60443-2242 | 2017-12-21 |
| 1184049413 | Nefatari Jones | Behavioral Analyst | 21136 Keeler Ave, Matteson, IL 60443-2242 | 2014-02-24 |
| 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 | 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 |
|---|---|---|---|---|
| 1932442571 | Laynie Foundation | Clinic/Center | 4747 Lincoln Mall Dr, Suite 604, Matteson, IL 60443-3811 | 2013-04-02 |
| 1902982127 | Center Services Inc | Clinic/Center | 3624 W 216th Street, Matteson, IL 60443-2713 | 2006-10-31 |
| 1811073034 | Dyann Inc | Clinic/Center | 3624 W 216th Street, Matteson, IL 60443-2713 | 2006-10-31 |
| 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 | ||||
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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.