GRAND PRAIRIE SERVICES (NPI# 1154896371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154896371 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
747 Red Oak Ln University Park IL 60484-2965 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7084441012 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086147831 |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-10-04 |
| Authorized Official Name | SHARRONNE WARD (PRESIDENT AND CEO) |
| Authorized Official Telephone | 7084441012 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRAND PRAIRIE SERVICES |
| 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 |
|---|---|---|---|---|
| 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 |
| 1093879371 | Grand Prairie Services | Clinic/Center | 1236 Ashland Ave, Chicago Heights, IL 60411-2544 | 2006-12-20 |
| Street Address |
747 RED OAK LN |
| City | UNIVERSITY PARK |
| State | IL |
| Zip Code | 60484-2965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898721 | Sophia Bracey | Registered Nurse | 443 Fairway Ct, University Park, IL 60484 | 2019-12-17 |
| 1225671019 | Colin D Kirchner | Counselor | 540 Circle Dr, University Park, IL 60484 | 2019-10-23 |
| 1437560505 | This Little Light | Durable Medical Equipment & Medical Supplies | 439 Doral Ter, University Park, IL 60484-2712 | 2014-05-12 |
| 1396232633 | Heather Williams | Chore Provider | 1 Thornwood Mall, University Park, IL 60484-2725 | 2018-04-20 |
| 1003205279 | Theresia Fonge | Non-emergency Medical Transport (VAN) | 4790 Hickory Creek Dr, Apt 8, University Park, IL 60484-2740 | 2015-01-12 |
| 1427366764 | Rupel Emmanuel Marshall Jr. | Pharmacist | 437 Brassie Ln, University Park, IL 60484-2775 | 2010-09-21 |
| 1972949261 | Lida Stewart | Developmental Therapist | 430 Brassie Ct, University Park, IL 60484-2777 | 2013-05-14 |
| 1053897736 | Grand Prairie Services | Clinic/Center | 759 Burr Oak Ln, University Park, IL 60484-2865 | 2018-07-16 |
| 1881086999 | Kay-kaymonique Pena | Social Worker | 706 Circle Dr, University Park, IL 60484-2907 | 2015-02-26 |
| 1174862213 | Norman Mays | Private Vehicle | 733 Union Dr, University Park, IL 60484-2918 | 2013-02-09 |
| Find all providers in zip 60484 | ||||
| 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 |
|---|---|---|---|---|
| 1053897736 | Grand Prairie Services | Clinic/Center | 759 Burr Oak Ln, University Park, IL 60484-2865 | 2018-07-16 |
| 1902152499 | The Pennsylvania State University | Clinic/Center | 501 Student Health Ctr, University Park, PA 16802-2129 | 2012-08-02 |
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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 | ||||
| City | UNIVERSITY PARK |
| Zip Code | 60484 |
Please comment or provide details below to improve the information on GRAND PRAIRIE SERVICES.
| 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.