RESURRECTION BEHAVIORAL HEALTH (NPI# 1760747257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760747257 |
| Entity Type | Organization |
| Organization Name | RESURRECTION BEHAVIORAL HEALTH |
| Other Organization Name | PROVISO FAMILY SERVICES |
| Practice Address |
1414 Main St Melrose Park IL 60160-3902 |
| Practice Telephone | 7086810073 |
| Practice Fax Number | 7086813958 |
| Mailing Telephone | 7086810073 |
| Mailing Fax Number | 7086813958 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | MR. DONALD PINKSTON (MANAGER) |
| Authorized Official Telephone | 7086810073 |
| Authorized Official Credential | LCSW |
| 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) |
178.007422 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Proviso family Services | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568706190 | Resurrection Behavioral Health | Community/Behavioral Health | 1127 N Oakley Blvd, Chicago, IL 60622-3507 | 2012-11-20 |
| 1083978324 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2012-07-02 |
| 1336406263 | Resurrection Behavioral Health | Respite Care | 1414 Main St, Melrose Park, IL 60160-3902 | 2012-04-17 |
| 1891079869 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-10-07 |
| 1629352695 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-10-07 |
| 1538441662 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-09-14 |
| Street Address |
1414 MAIN ST |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997193 | Anjali Dinesh Nair | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-21 |
| 1821603671 | Kehinde O Oyinloye | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-09 |
| 1093320814 | Shaquita Ramey | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-09 |
| 1821602723 | Yenisis Delossantos | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-08 |
| 1548871379 | Evelyn Darlene Simmons | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-08-14 |
| 1730707050 | Dianne E Lozano | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-07-13 |
| 1346867744 | Luz Luna | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-07-01 |
| 1396362166 | Felix Gatica | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-06-28 |
| 1992320485 | Mayra Diaz | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-06-10 |
| 1982243283 | Asmat Khan | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
| Find all providers in zip 60160 | ||||
| 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 |
|---|---|---|---|---|
| 1396080289 | Healthcare Alternative Systems | Clinic/Center | 1115 N 23rd Ave, Melrose Park, IL 60160-3139 | 2012-12-03 |
| 1598912867 | Presence Behavioral Health | Clinic/Center | 170 N 23rd Ave, Melrose Park, IL 60160-3635 | 2008-08-19 |
| 1083978324 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2012-07-02 |
| 1467720847 | Christine Case | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-12-13 |
| 1013285220 | Resurrection Health Care | Clinic/Center | 1414 Main, Melrose Park, IL 60160 | 2011-12-02 |
| 1245507573 | Resurrection Health Care | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-12-01 |
| 1891079869 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-10-07 |
| 1629352695 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-10-07 |
| 1538441662 | Resurrection Behavioral Health | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-09-14 |
| 1780831057 | Presence Behavioral Health | Clinic/Center | 1919 Main St, Melrose Park, IL 60160-3737 | 2008-08-19 |
| Find all providers in MELROSE PARK | ||||
| City | MELROSE PARK |
| Zip Code | 60160 |
Please comment or provide details below to improve the information on RESURRECTION BEHAVIORAL HEALTH.
| 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.