SUPPORTED INDEPENDENCE (NPI# 1649548405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649548405 |
| Entity Type | Organization |
| Organization Name | SUPPORTED INDEPENDENCE |
| Practice Address |
17009 Elm Drive Hazel Crest IL 60429 |
| Mailing Address |
17900 Elm Drive Hazel Crest IL 60429 |
| Practice Telephone | 6306677370 |
| Mailing Telephone | 6306677370 |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |
| Authorized Official Name | MRS. JESSICA LUCKETT (PRESIDENT) |
| Authorized Official Telephone | 6306677370 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467729137 | Supported Independence | Home Health | 17009 Elm Dr, Hazel Crest, IL 60429-1047 | 2011-11-24 |
| 1356633267 | Supported Independence | Private Vehicle | 30 S Wacker Dr, Suite 2200, Chicago, IL 60606-7413 | 2011-05-11 |
| 1528350808 | Supported Independence | Non-emergency Medical Transport (VAN) | 30 S Wacker Dr, Suite 2200, Chicago, IL 60606-7413 | 2011-05-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SUPPORTED INDEPENDENCE SERVICES OF OREGON, LLC | 255 Palomino Dr, Eugene, OR 97404 |
| Street Address |
17009 ELM DRIVE |
| City | HAZEL CREST |
| State | IL |
| Zip Code | 60429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917987 | Nancy Sinwelski | Technician | 17305 Fisk Street, East Hazelcrest, IL 60429 | 2019-11-21 |
| 1144720871 | Plentiful Hair Studio LLC | Specialist | 17504 E Carriageway Dr Ste D, Hazel Crest, IL 60429 | 2018-02-19 |
| 1376052142 | Natalie Allen | Counselor | 3518 Birchwood Dr, Hazel Crest, IL 60429 | 2017-09-25 |
| 1730534009 | Lydena Franklin | Counselor | 1909 Cheker Square, East Hazel Crest, IL 60429 | 2016-04-25 |
| 1710331053 | Lauiren Orta | Counselor | 1901 Cheker Square, E Hazel Crest, IL 60429 | 2016-04-22 |
| 1427423367 | Andrea Leigh Warren | Nurse Practitioner | 17800 S. Kedzie Ave, Hazel Crest, IL 60429 | 2015-12-03 |
| 1770969354 | Karriem's Developmental Services | Day Training, Developmentally Disabled Services | 18513 River Road, Hazel Crest, IL 60429 | 2015-08-05 |
| 1073905170 | James Kamper | Physical Therapy Assistant | 1816 W 170th Street, Hazel Crest, IL 60429 | 2015-02-26 |
| 1194066019 | Marilyn C Scott | Psychologist | 18505 Meadow Ln., Hazel Crest, IL 60429 | 2013-03-04 |
| 1336422617 | Daryel C. Wilson | Pharmacist | 18301 Pulaski Rd., Hazel Crest, IL 60429 | 2011-09-23 |
| Find all providers in zip 60429 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760706451 | Children's Home and Aid | Community/Behavioral Health | 17512 E Carriageway Dr, Hazel Crest, IL 60429-2091 | 2010-03-24 |
| 1639311087 | United Mental Health Organization of Illinois | Community/Behavioral Health | 17569 Kedzie Ave, Hazel Crest, IL 60429-2007 | 2009-04-01 |
| 1568634426 | Manna for Life Services, LLC | Community/Behavioral Health | 17541 Kedzie Ave, #346, Hazel Crest, IL 60429-2061 | 2008-03-31 |
| 1114415080 | Ican Dream Center Nfp | Community/Behavioral Health | 17512 E Carriageway Dr, Hazel Crest, IL 60429-2091 | 2018-04-26 |
| 1417217332 | Community Integrative Health Network | Community/Behavioral Health | 3330 W 177th St, Suite 1-f, Hazel Crest, IL 60429-2184 | 2012-05-24 |
| 1770818064 | Midwest Family and Community Resources PC | Community/Behavioral Health | 3330 W 177th St, Suite 1-f, Hazel Crest, IL 60429-2184 | 2009-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820648 | Community Wellness Group | Community/Behavioral Health | 635 Argyle Ave, Flossmoor, IL 60422-1201 | 2020-10-26 |
| 1437758711 | Gina Baldacci, Lcsw, LLC | Community/Behavioral Health | 231 Longridge Dr, Bloomingdale, IL 60108 | 2020-10-19 |
| 1790383610 | Joni Lamb Therapy, LLC | Community/Behavioral Health | 1555 Sherman Ave # 308, Evanston, IL 60201-4421 | 2020-10-13 |
| 1811594906 | Everyday Empowered Clinical Services, Ltd. | Community/Behavioral Health | 5117 Main St, Suite #7, Downers Grove, IL 60515 | 2020-10-02 |
| 1942817150 | Pacem Wellness, LLC | Community/Behavioral Health | 8 Eagle Ctr Ste 12, O Fallon, IL 62269-1947 | 2020-09-30 |
| 1831703271 | Boules Clinical Psychology Group | Community/Behavioral Health | 200 S Frontage Rd Ste 324, Burr Ridge, IL 60527-6953 | 2020-09-02 |
| 1336753896 | Counseling Kennedy Shenberg | Community/Behavioral Health | 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 | 2020-09-02 |
| 1265045371 | Brightside Recovery | Community/Behavioral Health | 1667 Belvidere Rd, Belvidere, IL 61008-9306 | 2020-08-28 |
| 1902419021 | Brightside Recovery | Community/Behavioral Health | 8041 186th St Ste B, Tinley Park, IL 60487-9344 | 2020-08-28 |
| 1700498573 | Bobby E. Wright Comprehensive Behavioral Health Center, Inc. | Community/Behavioral Health | 5816 W Division St Fl 1, Chicago, IL 60651-1003 | 2020-08-21 |
| Find all providers with the same taxonomy | ||||
| City | HAZEL CREST |
| Zip Code | 60429 |
Please comment or provide details below to improve the information on SUPPORTED INDEPENDENCE.
| 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.