MR. MIKKAL HARRIS (NPI# 1942537477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942537477 |
| Entity Type | Individual |
| Full Name | MR. MIKKAL HARRIS |
| Credential | LCPC |
| Practice Address |
4749 Lincoln Mall Dr #202 Matteson IL 60443-2348 |
| Mailing Address |
8660 S 86th Ave #310 Justice IL 60458-2127 |
| Practice Telephone | 7088338887 |
| Practice Fax Number | 7088270555 |
| Mailing Telephone | 7737331773 |
| Mailing Fax Number | 7084587930 |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
180007145 | IL | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
180007145 | IL | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 180007145 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4749 LINCOLN MALL DR #202 |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-2348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730395559 | Athletico Ltd | Physical Therapist | 4749 Lincoln Mall Dr, Suite 550, Matteson, IL 60443-2348 | 2007-05-16 |
| 1023387289 | Abigail Lynn Ruklic | Specialist/Technologist | 4749 Lincoln Mall Dr, Suite 550, Matteson, IL 60443-2348 | 2011-12-17 |
| 1790076628 | Laynie Foundation | Community/Behavioral Health | 4749 Lincoln Mall Dr, Suite 202, Matteson, IL 60443-2348 | 2011-04-26 |
| 1194048108 | Pinhas Sharon Md, LLC | Internal Medicine | 4749 Lincoln Mall Dr, Suite 204, Matteson, IL 60443-1180 | 2010-03-04 |
| 1811152515 | Ayesha D Griffin | Physical Therapist | 4749 Lincoln Mall Dr, Suite 550, Matteson, IL 60443-2348 | 2008-07-22 |
| 1760653562 | Wendy Ceko | Physical Therapist | 4749 Lincoln Mall Dr, Suite 550, Matteson, IL 60443-2348 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1407166978 | Taunya Woods | Counselor | 600 Holiday Plaza Dr Ste 130, Matteson, IL 60443-2236 | 2010-10-18 |
| 1649436650 | Sarah A Wiemeyer | Counselor | 4331 211th St, Matteson, IL 60443-2404 | 2008-07-30 |
| 1205043437 | Changing Perspectives, Inc. | Counselor | 3624 216th St, Matteson, IL 60443-2713 | 2007-05-17 |
| 1306490420 | Jeanne Weber | Counselor | 3624 216th St, Matteson, IL 60443-2713 | 2019-07-26 |
| 1225696958 | Adrienne Lambert | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-29 |
| 1235796236 | Mary K Aitchison | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-24 |
| 1366901290 | Amanda Briick | Counselor | 4747 Lincoln Mall Dr, Matteson, IL 60443-3811 | 2019-03-19 |
| 1730663782 | Jason David Hickmott | Counselor | 3624 216th St, Matteson, IL 60443-2713 | 2018-09-15 |
| 1528593027 | Maureen L Fitzmaurice | Counselor | 3624 216th St, Matteson, IL 60443-2713 | 2017-04-22 |
| Find all providers in MATTESON | ||||
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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.