GRAND PRAIRIE SERVICES (NPI# 1730363458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730363458 |
Entity Type | Organization |
Organization Name | GRAND PRAIRIE SERVICES |
Practice Address |
17850 Baker Ave Country Club Hills IL 60478-4729 |
Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
Practice Telephone | 7084441012 |
Mailing Telephone | 7084441012 |
Mailing Fax Number | 7086149449 |
Enumeration Date | 2007-12-18 |
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 |
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 |
1093879371 | Grand Prairie Services | Clinic/Center | 1236 Ashland Ave, Chicago Heights, IL 60411-2544 | 2006-12-20 |
Street Address |
17850 BAKER AVE |
City | COUNTRY CLUB HILLS |
State | IL |
Zip Code | 60478-4729 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831728245 | Erica Jefferson | Case Manager/Care Coordinator | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2020-04-07 |
1376840967 | Pamela L Velazquez | Behavioral Analyst | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2011-02-17 |
1962708545 | Gwendolyn L Johnson | Behavioral Analyst | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2011-01-31 |
1447554969 | Bertha M Miller | Behavioral Analyst | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2010-12-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285266296 | Infinity Love Care LLC | Hospice Care, Community Based | 1153 Williamsburg Road, Country Club Hills, IL 60478 | 2020-02-07 |
1467911313 | Atlas & Associates, Inc | Durable Medical Equipment & Medical Supplies | 4907 Sunset Lane, Country Club Hills, IL 60478 | 2019-03-19 |
1780196022 | Katrina Crosby | Non-emergency Medical Transport (VAN) | 18261 Ravisloe Terrace, Country Club Hills, IL 60478 | 2017-10-26 |
1063949675 | Rashunda Lee | Nurse Practitioner | 17469 Park Lane, Country Club Hills, IL 60478 | 2017-05-12 |
1558809947 | Jaylin Omauri Banks | Specialist/Technologist | 17791 Princeton Lane, Country Club Hills, IL 60478 | 2017-02-06 |
1083072276 | Lynn Banks | Occupational Therapy Assistant | 17800 Rosewood Terrace, Country Club Hills, IL 60478 | 2016-02-03 |
1215323019 | Norm Brown | Case Management | 19432 Elm Dr, Country Club Hills, IL 60478 | 2015-04-09 |
1265841746 | Glorinda Conley Henry | Health Educator | 4131 W. 192nd Pl., Country Club Hills, IL 60478 | 2014-08-08 |
1447663398 | Lillian Moore | Nurse Practitioner | 4724 West 175th Place, Country Club Hills, IL 60478 | 2014-06-09 |
1578999348 | Ihuoma C Ozoh | Pharmacist | 18331 Mulberry Terrace, Country Club Hills, IL 60478 | 2013-09-24 |
Find all providers in zip 60478 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
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---|---|---|---|---|
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 | COUNTRY CLUB HILLS |
Zip Code | 60478 |
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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.