KIRBY REHABILITATION, INC (NPI# 1871966382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871966382 |
| Entity Type | Organization |
| Organization Name | KIRBY REHABILITATION, INC |
| Other Organization Name | KIRBY REHABILITATION |
| Practice Address |
723 W. 111th St Chicago IL 60628 |
| Practice Telephone | 7736144002 |
| Practice Fax Number | 7734533262 |
| Mailing Telephone | 7736144002 |
| Mailing Fax Number | 7734533262 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2018-05-16 |
| Authorized Official Name | MISS LEA KIRBY (PRESIDENT) |
| Authorized Official Telephone | 7736144002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
CA8419-0001 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CA8419-0001 | 05 |
| Other Name | Type Code |
|---|---|
| Kirby Rehabilitation | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KIRBY REHABILITATION, INC. | 723 W 111th St, Chicago, IL 60628-3902 |
| Street Address |
723 W. 111TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857942 | Myrna Pledger | Counselor | 259 W. 104th Pl., Chicago, IL 60628 | 2018-10-16 |
| 1073097184 | 4every1 Lab Inc. | Clinical Medical Laboratory | 10723 S Halsted St, Chicago, IL 60628 | 2018-09-24 |
| 1922594613 | Northwest Adult Wellness Center LLC | Clinic/Center | 235 W 95th Suite 3, Chicago, IL 60628 | 2018-07-05 |
| 1285152801 | Brittany Bellamy | Developmental Therapist | 10333 S Prairie, Chicago, IL 60628 | 2017-09-04 |
| 1598293839 | Denise Marie Mercherson | Social Worker | 9561 S. Union, Chicago, IL 60628 | 2017-05-31 |
| 1659821221 | Tca Health Care | Dentist | 1030 E. 130th St, Chicago, IL 60628 | 2016-10-07 |
| 1528432697 | Global Dialysis, LLC | Registered Nurse | 9746 South Harvard Ave., Chicago, IL 60628 | 2015-11-30 |
| 1851638605 | Marketa Marvanova | Pharmacist | 9501 S. King Drive, Douglas Hall 203-23, Chicago State University College of Pharmacy, Chicago, IL 60628 | 2013-01-14 |
| 1841567377 | Emma Goodman | Pharmacist | 10620 S. Halsted St, Chicago, IL 60628 | 2011-11-29 |
| 1043525496 | Eve Packer | Registered Nurse | 33 E, 114th Street, Chicago, IL 60628 | 2010-08-10 |
| Find all providers in zip 60628 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1053957993 | Safer Foundation | Clinic/Center | 769 W Jackson, Unit G, Chicago, IL 60661 | 2019-11-26 |
| 1255977195 | Safer Foundation | Clinic/Center | 6352 W Grand Ave, Chicago, IL 60639-2650 | 2019-11-26 |
| 1063068492 | The Threshold | Clinic/Center | 3015 W Harrison St, Chicago, IL 60612 | 2019-08-12 |
| 1790338150 | Solleys House | Clinic/Center | 4163 S Archer Ave, Chicago, IL 60632-1870 | 2019-07-24 |
| 1366925489 | Lurie Children's Adolescent Substance Abuse and Prevention Progarm | Clinic/Center | 1440 N Dayton St, Chicago, IL 60642-2644 | 2018-09-13 |
| 1710482815 | Gateway Foundation, Inc. | Clinic/Center | 415 N Dearborn St Ste 510, Chicago, IL 60654-4626 | 2018-03-29 |
| 1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
| 1053836395 | Aunt Martha's Health and Wellness, Inc. | Clinic/Center | 5001 S Michigan Ave Ste B, Chicago, IL 60615-2112 | 2017-08-08 |
| 1437679255 | Sixto Garcia | Clinic/Center | 1100 W. Cermak Rd, Chicago, IL 60608 | 2017-06-22 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on KIRBY REHABILITATION, INC.
| 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.