KEISHA KIMBLE (NPI# 1265994735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265994735 |
| Entity Type | Individual |
| Full Name | KEISHA KIMBLE |
| Practice Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7084441150 |
| Practice Fax Number | 7084441156 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086147831 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
17746 OAK PARK AVE |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60477-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346304979 | Grand Prairie Services | Clinic/Center | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2006-12-20 |
| 1407464860 | Brian Williams | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2020-07-21 |
| 1073157939 | Ryan Thomas | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| 1154965010 | Fred Groves | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| 1831742345 | Naisa Holmes | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-07-23 |
| 1801454699 | Patricia Young | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-06-05 |
| 1740747567 | Pleashette Pinkston | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-02-28 |
| 1386100568 | Renee Watson | Case Manager/Care Coordinator | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-02-13 |
| 1134693070 | Levon Davis | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-01-14 |
| 1740764414 | Sharron Hannah | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2018-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522366 | Joshua Gruenke | Physical Therapist | 17129 S. Harlem Avenue, Tinley Park, IL 60477 | 2020-09-14 |
| 1881229656 | Sherrie Lynn Tsang | Massage Therapist | 7925 West 171st Street, Tinley Park, IL 60477 | 2020-03-11 |
| 1437782117 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 17129 S Harlem Ave. Ste B3, Tinley Park, IL 60477 | 2020-02-20 |
| 1356998561 | Rasa Vaskeviciute | Physical Therapist | 17129 So Harlem, Tinley Park, IL 60477 | 2019-08-22 |
| 1538728258 | Michelle Anne Wisen | Physical Therapy Assistant | 17129 South Harlem, Suite B3, Tinley Park, IL 60477 | 2019-06-06 |
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1316445794 | Yvonne Tran | Physical Therapist | 17129 S Harlem Ave, Tinley Park, IL 60477 | 2018-01-31 |
| 1326574591 | Nicholas Barker | Chronic Disease Hospital | 7859 Joliet Drive North, Tinley Park, IL 60477 | 2017-05-10 |
| 1982063632 | Nicole Kristine Demarco | Specialist/Technologist | 16317 Clark Ln, Tinley Park, IL 60477 | 2016-02-22 |
| 1376900571 | Ucp Seguin Greater Chicago | Foster Care Agency | 7550 W. 183rd, Tinley Park, IL 60477 | 2016-01-20 |
| Find all providers in zip 60477 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1821524984 | Stephen Sarsany | Counselor | 7341 Sandalwood Dr Apt 101, Tinley Park, IL 60477-3747 | 2017-05-11 |
| 1740606821 | Lauren Houlihan | Counselor | 8524 Steeple Dr, Tinley Park, IL 60487-2253 | 2014-03-12 |
| 1558784942 | Deanna L Stacy | Counselor | 15941 Harlem Ave # 140, Tinley Park, IL 60477-1609 | 2014-01-22 |
| 1386944510 | Barbara Ann Smurzynski | Counselor | 17255 Oak Park Ave # Ue, Tinley Park, IL 60477-3401 | 2010-10-21 |
| 1407464860 | Brian Williams | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2020-07-21 |
| 1770101784 | Blazing Trails Counseling, Pllc | Counselor | 15941 Harlem Ave # 140, Tinley Park, IL 60477-1609 | 2020-07-07 |
| 1124659313 | Lauren Alexandra Mock | Counselor | 18350 Crossing Dr, Tinley Park, IL 60487-6294 | 2020-01-28 |
| 1073157939 | Ryan Thomas | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| 1154965010 | Fred Groves | Counselor | 17746 Oak Park Ave, Tinley Park, IL 60477-3936 | 2019-11-04 |
| Find all providers in TINLEY PARK | ||||
| City | TINLEY PARK |
| Zip Code | 60477 |
Please comment or provide details below to improve the information on KEISHA KIMBLE.
| 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.