SERTOMA CENTRE, INC. (NPI# 1306170592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306170592 |
| Entity Type | Organization |
| Organization Name | SERTOMA CENTRE, INC. |
| Practice Address |
4100 W 127th St Alsip IL 60803-1925 |
| Mailing Address |
4343 W 123rd St Alsip IL 60803-1807 |
| Practice Telephone | 7083719700 |
| Practice Fax Number | 7083719700 |
| Mailing Telephone | 7083719700 |
| Mailing Fax Number | 7083719747 |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |
| Authorized Official Name | MR. GUS VAN DEN BRINK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7083719700 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417431537 | Sertoma Centre, Inc. | Case Management | 4331 Lincoln Hwy Ste A, Matteson, IL 60443-2472 | 2018-09-25 |
| 1235241720 | Sertoma Centre, Inc. | Voluntary or Charitable | 4343 W 123rd St, Alsip, IL 60803-1807 | 2006-08-31 |
| 1982201414 | Sertoma Centre, Inc. | Clinic/Center | 4343 W 123rd St, Alsip, IL 60803-1807 | 2020-10-07 |
| 1194348359 | Sertoma Centre, Inc. | Voluntary or Charitable | 4100 W 127th St, Alsip, IL 60803-1925 | 2020-05-22 |
| 1013240423 | Sertoma Centre, Inc. | Voluntary or Charitable | 4331 Lincoln Hwy, Suite A, Matteson, IL 60443-2404 | 2009-09-16 |
| Street Address |
4100 W 127TH ST |
| City | ALSIP |
| State | IL |
| Zip Code | 60803-1925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348359 | Sertoma Centre, Inc. | Voluntary or Charitable | 4100 W 127th St, Alsip, IL 60803-1925 | 2020-05-22 |
| 1427683697 | Melanie Davis | Counselor | 4100 W 127th St, Alsip, IL 60803-1925 | 2020-03-09 |
| 1861853327 | Ashley Schehr | Counselor | 4100 W 127th St, Alsip, IL 60803-1925 | 2016-03-11 |
| 1861896896 | Adam Becerra | Counselor | 4100 W 127th St, Alsip, IL 60803-1925 | 2014-10-20 |
| 1568770378 | Heather Beckner | Counselor | 4100 W 127th St, Alsip, IL 60803-1925 | 2010-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699173013 | American Medical Lab, Ltd | Clinical Medical Laboratory | 5130 W 125th Pl, American Medical Lab, Alsip, IL 60803 | 2014-12-17 |
| 1225387574 | A Touch of Class Dentistry II | Dentist | 12033 S. Pulaski Road, Alsip, IL 60803 | 2012-08-31 |
| 1841431657 | George P. Danos Inc | Dentist | 5101 W 111th St, Alsip, IL 60803 | 2009-03-09 |
| 1194898114 | Vital Rehabilitation & Physical Therapy Inc | Clinic/Center | 11600 S Kedzie, Merrionette Park, IL 60803 | 2006-11-16 |
| 1841203650 | Alsip Dental Arts PC | Dentist | 11107 South Lawler, Alsip, IL 60803 | 2006-08-14 |
| 1477500932 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 12001 S Pulaski Rd, Alsip, IL 60803 | 2006-05-30 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 1467064360 | Yash Desai | Pharmacist | 12290 S Pulaski Rd, Alsip, IL 60803 | 2020-08-20 |
| 1609293539 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3243 W 115th St, Merrionette Park, IL 60803 | 2014-03-28 |
| 1114357092 | Abdul Hussein Darki | Pediatrics | 11808 S Pulaski Rd, Alsip, IL 60803 | 2013-11-14 |
| Find all providers in zip 60803 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235241720 | Sertoma Centre, Inc. | Voluntary or Charitable | 4343 W 123rd St, Alsip, IL 60803-1807 | 2006-08-31 |
| 1194348359 | Sertoma Centre, Inc. | Voluntary or Charitable | 4100 W 127th St, Alsip, IL 60803-1925 | 2020-05-22 |
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| 1366817017 | Englewood Community Connection Outreach | Voluntary or Charitable | 7326 S Exchange Ave, Chicago, IL 60649-3408 | 2015-12-07 |
| 1508235060 | Southeastern Il Agency On Aging, Inc | Voluntary or Charitable | 516 N Market St, Mount Carmel, IL 62863-1558 | 2015-09-15 |
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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.