CTF ILLINOIS (NPI# 1699372250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699372250 |
| Entity Type | Organization |
| Organization Name | CTF ILLINOIS |
| Other Organization Name | CTF ILLINOIS -REYNOLDS MH |
| Practice Address |
1400 Reynolds Dr Charleston IL 61920-2411 |
| Mailing Address |
18230 Orland Pkwy Orland Park IL 60467-5688 |
| Practice Telephone | 7084291260 |
| Mailing Telephone | 7082941260 |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-10-09 |
| Authorized Official Name | KELLI L CODY (EXECUTIVE ASSISTANT) |
| Authorized Official Telephone | 7084291260 |
| Is Organization Subpart | Y |
| Parent Organization Name | CTF ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CTF Illinois -Reynolds MH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356706881 | Ctf Illinois | Clinic/Center | 530 E 162nd St, South Holland, IL 60473-2326 | 2015-12-29 |
| 1609231778 | Ctf Illinois | Day Training, Developmentally Disabled Services | 18230 Orland Pkwy, Orland Park, IL 60467-5688 | 2015-12-16 |
| 1194183699 | Ctf Illinois | Non-emergency Medical Transport (VAN) | 530 E 162nd St, South Holland, IL 60473-2326 | 2016-01-29 |
| 1770949661 | Ctf Illinois | Clinic/Center | 18230 Orland Pkwy, Orland Park, IL 60467-5688 | 2016-01-07 |
| 1447615513 | Ctf Illinois | Clinic/Center | 19015 S Jodi Rd, Mokena, IL 60448-8514 | 2015-12-16 |
| Street Address |
1400 REYNOLDS DR |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| 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 |
|---|---|---|---|---|
| 1598305138 | Kg Psychotherapy LLC | Clinic/Center | 711a Saint Andrews Blvd Ste A, Charleston, SC 29407-7140 | 2020-01-12 |
| 1407499072 | Klw Counseling & Consulting, LLC | Clinic/Center | 125 Wappoo Creek Dr Ste G, Charleston, SC 29412-2162 | 2019-10-25 |
| 1679060420 | Partnership of African American Churches Inc. | Clinic/Center | 1514 Kanawha Blvd W, Charleston, WV 25387-2533 | 2018-04-17 |
| 1386851509 | Kanawha Valley Center Inc | Clinic/Center | 200 Bradford Street, Charleston, WV 25301-5301 | 2007-05-17 |
| 1659382703 | Highland Behavioral Health Services Inc | Clinic/Center | 511 Morris Street, Charleston, WV 25301 | 2006-08-11 |
| 1740291897 | Highland Behavioral Health Services Inc | Clinic/Center | 5600 Maccorkle Ave Se, Suite 6, Charleston, WV 25304 | 2006-08-11 |
| 1225645005 | Mikayla Harper, LLC | Clinic/Center | 452 Folly Rd, Charleston, SC 29412-2641 | 2020-09-25 |
| 1154840841 | Mbh Physician Group -wv Pllc | Clinic/Center | 1418 Maccorkle Ave Sw, Charleston, WV 25303-1342 | 2017-09-13 |
| 1760896740 | Highland Behavioral Health Services, Inc | Clinic/Center | 2500 Cherokee Avenue, Charleston, WV 25304 | 2014-06-17 |
| 1164639373 | Kanawha Valley Center Inc | Clinic/Center | 200 Bradford Street, Charleston, WV 25301-5301 | 2007-05-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
Please comment or provide details below to improve the information on CTF ILLINOIS.
| 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.