BRONZEVILLE ACADMEY CHARTER SCHOOL (NPI# 1710538004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710538004 |
| Entity Type | Organization |
| Organization Name | BRONZEVILLE ACADMEY CHARTER SCHOOL |
| Practice Address |
4930 S Cottage Grove Ave Chicago IL 60615-2616 |
| Practice Telephone | 3126855002 |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |
| Authorized Official Name | ALVIN BOUTTE (CEO) |
| Authorized Official Telephone | 3126855002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251300000X | Local Education Agency (LEA) | Agencies |
| Other Name | Type Code |
|---|---|
| Bronzeville Acadmey Charter School | Doing Business As Name - Organization |
| Street Address |
4930 S COTTAGE GROVE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60615-2616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124664602 | Carol Ann Brunkowski | Psychologist | 4930 S Cottage Grove Ave, Chicago, IL 60615-2616 | 2019-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170221 | Cook County | Technician, Other | 430 East 51st Pl, Chicago, IL 60615 | 2020-09-28 |
| 1700498326 | Connie Frances Davis | Massage Therapist | 5481 S. Cornell, Chicago, IL 60615 | 2020-08-17 |
| 1134781974 | Lifestyle Rejuvenation Medical Group Pllc | Chiropractor | 1740 E 55th Street, Chicago, IL 60615 | 2019-07-02 |
| 1275007767 | Michelle Alyse Costello | Social Worker | 1225 E 53rd St, Suite 606, Chicago, IL 60615 | 2019-01-17 |
| 1194207522 | Cindy Louise Lys | Social Worker | 1525 E 53rd Street Suite 516-4, Chicago, IL 60615 | 2018-09-01 |
| 1861983660 | Pranusha Pinna | Student in an Organized Health Care Education/Training Program | 1850 W. Harrison St., Chicago, IL 60615 | 2018-05-29 |
| 1528577632 | Jonah Waseberg | Counselor | 1100 E.55th St, Chicago, IL 60615 | 2017-09-21 |
| 1710404496 | Tawann Jackson | Psychologist | 360 Blair Lane, Door 13, Bolingbrook, IL 60615 | 2017-08-24 |
| 1194259069 | Molly Kachale Netter | Nurse Practitioner | 1554 E 55th St., Chicago, IL 60615 | 2017-04-17 |
| 1205387990 | Kirk Remon Riddle | Counselor | 1525 E. 53rd Street, Suite 425, Chicago, IL 60615 | 2016-10-18 |
| Find all providers in zip 60615 | ||||
| Taxonomy Code | 251300000X |
| Grouping | Agencies |
| Classification | Local Education Agency (LEA) |
| The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy. |
| Notes: Source: Portions of IDEA Regulations Part B (34 CFR Part 300.18, Assistance to States for the Education of Children with Disabilities) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629603220 | Horizon Science Academy-belmont | Local Education Agency (LEA) | 2456 N Mango Ave, Chicago, IL 60639-2313 | 2020-03-04 |
| 1740815331 | Horizon Science Academy-mckinley Park | Local Education Agency (LEA) | 2245 W Pershing Rd, Chicago, IL 60609-2211 | 2020-03-04 |
| 1689223653 | Intrinsic Schools | Local Education Agency (LEA) | 79 W Monroe St Ste 400, Chicago, IL 60603-4903 | 2019-09-11 |
| 1992352645 | Amandla Charter School | Local Education Agency (LEA) | 6820 S Washtenaw Ave, Chicago, IL 60629-1826 | 2019-08-19 |
| 1497205744 | Betty Shabazz Interantional Charter School | Local Education Agency (LEA) | 7823 S Ellis Ave, Chicago, IL 60619-3213 | 2016-10-11 |
| 1386070589 | Ace Tech Charter Hs | Local Education Agency (LEA) | 5410 S State St, Chicago, IL 60609-6342 | 2013-09-19 |
| 1295077337 | Central Stickney Sd #110 | Local Education Agency (LEA) | 5001 Lane Ave., Chicago, IL 60638-1733 | 2013-03-26 |
| 1295061372 | Central Stickney School District #110 | Local Education Agency (LEA) | 5001 S Long Ave, Chicago, IL 60638-1733 | 2009-10-26 |
| 1083860845 | Alivio Medical Center, Inc. | Local Education Agency (LEA) | Alivio Medical Ctr, 75 Remittance Dr. Suite 6577, Chicago, IL 60675-6577 | 2008-08-13 |
| 1467647883 | Illinois Center for Rehabilitation and Education | Local Education Agency (LEA) | 1950 W Roosevelt Rd, Chicago, IL 60608-1245 | 2007-09-10 |
| 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.