GRAND PRAIRIE SERVICES (NPI# 1952465494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952465494 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
14447 S Bensley Ave Burnham IL 60633-2224 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7088620212 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086149449 |
| Enumeration Date | 2006-12-20 |
| 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 |
| 1730363458 | Grand Prairie Services | Clinic/Center | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2007-12-18 |
| 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 |
| Street Address |
14447 S BENSLEY AVE |
| City | BURNHAM |
| State | IL |
| Zip Code | 60633-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407321458 | Jasa Perry | Counselor | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2018-10-05 |
| 1871004887 | Lacretia Brazzleton | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-10-17 |
| 1851810436 | James Bryan | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-09-14 |
| 1245750710 | Kenon Harding | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-06-26 |
| 1295264976 | Daniel Brown | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-06-07 |
| 1205134483 | Cherita D Epps | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2011-03-11 |
| 1619271236 | Phillip Jackson | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2010-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154749513 | Ronald Paetsch I | Physical Therapy Assistant | 14500 S Manistee Ave., Burnham, IL 60633 | 2014-04-02 |
| 1033547914 | Sharron Lynese Mckee | Social Worker | 14545 South Manistee Ave., Unit 2c, Burnham, IL 60633 | 2013-10-31 |
| 1104437904 | Aracely Delreal | Counselor | 2753 E 127th St, Chicago, IL 60633-1128 | 2020-08-14 |
| 1790270965 | Emily Therese Opiola | Nurse Practitioner | 12816 S Muskegon Ave, Chicago, IL 60633-1243 | 2018-06-28 |
| 1144464322 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 3125 E 131st St, Chicago, IL 60633-1315 | 2009-05-01 |
| 1750468534 | James Egan | Chiropractor | 13101 S Baltimore Ave, Chicago, IL 60633-1318 | 2006-11-01 |
| 1194083766 | Joseph Pantano | Physical Therapy Assistant | 13002 S Brandon Ave, Chicago, IL 60633-1321 | 2012-05-02 |
| 1669039020 | Nikolina Medina | Speech-Language Pathologist | 13131 S Buffalo Ave, Chicago, IL 60633-1326 | 2019-05-21 |
| 1790811545 | Efstathia Maria Saranteas | Acupuncturist | 13144 S Buffalo Ave, Chicago, IL 60633-1327 | 2007-02-26 |
| 1972692812 | James M Goril | Dentist | 13247 S Baltimore Ave, Chicago, IL 60633-1431 | 2006-10-11 |
| Find all providers in zip 60633 | ||||
| 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 | ||||
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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.