COMMUNITY WELLNESS GROUP (NPI# 1144820648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144820648 |
| Entity Type | Organization |
| Organization Name | COMMUNITY WELLNESS GROUP |
| Practice Address |
635 Argyle Ave Flossmoor IL 60422-1201 |
| Practice Telephone | 7738448813 |
| Mailing Telephone | 7738448813 |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |
| Authorized Official Name | DR. SHIRLYN MARIA GARRETT-WILSON (VICE PRESIDENT OF CLINICAL SERVICES) |
| Authorized Official Telephone | 7733209592 |
| Authorized Official Credential | ED.D., LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 19002 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18631 Laramie Rd, Country Club Hills, IL 604784412 | 7733209592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982144606 | Community Wellness Group | Counselor | 9019 Garners Ferry Rd Ste B, Hopkins, SC 29061-9687 | 2017-02-28 |
| Street Address |
635 ARGYLE AVE |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-1201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| 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 |
|---|---|---|---|---|
| 1447212543 | Grand Prairie Services | Clinic/Center | 19530 Kedzie Avenue, Flossmoor, IL 60422 | 2006-04-04 |
| 1336158088 | Human Services, Inc. | Clinic/Center | 3235 Vollmer Rd, Suite 119, Flossmoor, IL 60422-2013 | 2006-08-05 |
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| 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.