AUTUMN HEALTHCARE OF ILLINOIS (NPI# 1205317377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205317377 |
| Entity Type | Organization |
| Organization Name | AUTUMN HEALTHCARE OF ILLINOIS |
| Practice Address |
9449 S Kedzie Ave Suite 142 Evergreen Pk IL 60805-2325 |
| Mailing Address |
9449 S Kedzie Ave Evergreen Pk IL 60805-2325 |
| Practice Telephone | 7734203481 |
| Mailing Telephone | 7734203481 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-12-13 |
| Authorized Official Name | JAMES BROWN (OFFICE MANAGER) |
| Authorized Official Telephone | 7738527454 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679628705 | Autumn Healthcare of Illinois | Counselor | 4505 S Drexel Blvd, Chicago, IL 60653-4301 | 2007-01-25 |
| Street Address |
9449 S KEDZIE AVE SUITE 142 |
| City | EVERGREEN PK |
| State | IL |
| Zip Code | 60805-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831569 | Chicago Psychiatric LLC | Clinic/Center | 800 W Cornelia Ave Apt 303, Chicago, IL 60657-2086 | 2020-11-03 |
| 1184223133 | Kevin P. Mcdunn, Psyd, LLC | Clinic/Center | 605 W Madison St Apt 2001, Chicago, IL 60661-2469 | 2020-10-21 |
| 1699372250 | Ctf Illinois | Clinic/Center | 1400 Reynolds Dr, Charleston, IL 61920-2411 | 2020-10-07 |
| 1124634852 | Prosper Counseling Services | Clinic/Center | 808 W Junior Ter Apt 303, Chicago, IL 60613-1657 | 2020-09-17 |
| 1962017665 | Hopeology, Pllc | Clinic/Center | 700 E North St Ste B, Elburn, IL 60119-7009 | 2020-09-10 |
| 1013521301 | Self Connected Therapy LLC | Clinic/Center | 2189 N. Rt. 83, #292, Round Lake Beach, IL 60073 | 2020-09-03 |
| 1508479288 | Bash Psychotherapy Corporation | Clinic/Center | 413 E Berry Rd, Barrington, IL 60010-3317 | 2020-08-24 |
| 1326658402 | Ventura Counseling, LLC | Clinic/Center | 620 Manchester Ave, Westchester, IL 60154-2714 | 2020-08-04 |
| 1265040760 | Orchid Counseling Chicago | Clinic/Center | 451 W Melrose St Apt 610, Chicago, IL 60657-3826 | 2020-07-21 |
| 1164040630 | Sunshine Therapy Pllc | Clinic/Center | 3328 N Bell Ave, Chicago, IL 60618-6204 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PK |
| Zip Code | 60805 |
Please comment or provide details below to improve the information on AUTUMN HEALTHCARE OF ILLINOIS.
| 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.