SOUTH SHORE LAKE FRONT SERVICES, INC (NPI# 1013932748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013932748 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE LAKE FRONT SERVICES, INC |
| Practice Address |
2619 E 75th St # 21 Chicago IL 60649-3705 |
| Practice Telephone | 7733751900 |
| Practice Fax Number | 7737852091 |
| Mailing Telephone | 7733751900 |
| Mailing Fax Number | 7737852091 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | DR. LEONARD GO (DOCTOR) |
| Authorized Official Telephone | 7733751900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
IL | Behavioral Health & Social Service Providers |
| Street Address |
2619 E 75TH ST # 21 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60649-3705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| 1477178713 | Angela K Coleman | Counselor | 1955 E 71st Street, Chicago, IL 60649 | 2020-06-12 |
| 1245880715 | Familydoc Urgent Care LLC | Clinic/Center | 7201 S Stony Island Ave, Chicago, IL 60649 | 2019-09-17 |
| 1912498668 | Venessel N/a Woodson I | Radiology | 7674 S. Southshore Dr #1n, Chicago, IL 60649 | 2018-05-29 |
| 1689117764 | Susana Jimenez | Occupational Therapy Assistant | 2649 E. 75th St, Chicago, IL 60649 | 2016-11-22 |
| 1063863579 | Regina Whittmon | Driver | 7808 S Coles Ave Apt 3, Chicago, IL 60649 | 2016-06-27 |
| 1174912356 | Montsho Gallardo | Doula | 7653 S Coles Ave, Chicago, IL 60649 | 2015-01-12 |
| 1780922120 | April Ong | Physical Therapist | 6700 S Oglesby Ave, Apt 1906, Chicago, IL 60649 | 2013-01-18 |
| 1114288594 | Days Adult Day Care and Personal Care Providers Inc | Clinic/Center | 2455 E 75th St, Chicago, IL 60649 | 2012-06-02 |
| 1891064887 | Kevin Forrest | Occupational Therapist | 2425 E. 71st Street, Chicago, IL 60649 | 2011-12-20 |
| Find all providers in zip 60649 | ||||
| Taxonomy Code | 103TP2701X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Group Psychotherapy |
| Definition to come... |
| Notes: [1/1/2007: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487127668 | Robert Petite | Psychologist | 4717 S Greenwood Ave, Chicago, IL 60615-1933 | 2019-01-09 |
| 1275798308 | Options Medical Services Inc. | Psychologist | 4444 S Michigan Ave, Chicago, IL 60653-3117 | 2008-07-29 |
| 1710162862 | Wise Behavioral Health Services Ltd | Psychologist | 9012 S Crandon Ave, Chicago, IL 60617-3807 | 2008-01-08 |
| 1083894679 | Helping Hands Care Services | Psychologist | 1101 S Austin Blvd, Chicago, IL 60644-5318 | 2007-11-12 |
| 1982803219 | Institute for Behavioral Health | Psychologist | 4250 N Marine Dr Apt 1521, Chicago, IL 60613-1714 | 2007-07-17 |
| 1982808655 | Acorn Rehab Services Ltd | Psychologist | 4639 W Washington Blvd, Chicago, IL 60644-3618 | 2007-06-14 |
| 1386671279 | South Haven Behavioral Modification II Inc | Psychologist | 448-454 E. 61st St, Chicago, IL 60637 | 2006-06-27 |
| 1285680645 | Phoenix Healthcare Services LLC | Psychologist | 7324 N Western Ave, Chicago, IL 60645-1814 | 2006-05-26 |
| 1760436398 | Associated Behavioral Consultants, Inc | Psychologist | 4835 W Irving Park Rd, Chicago, IL 60641-2719 | 2006-05-19 |
| 1881643906 | Lakeshorehealthcare | Psychologist | 4444 W Montrose Ave, Chicago, IL 60641-2023 | 2006-05-08 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on SOUTH SHORE LAKE FRONT SERVICES, 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.