GRAND PRAIRIE SERVICES (NPI# 1447212543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447212543 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
19530 Kedzie Avenue Flossmoor IL 60422 |
| Mailing Address |
17746 S Oak Avenue Tinley Park IL 60477 |
| Practice Telephone | 7087992200 |
| Practice Fax Number | 7087992711 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086149449 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | SHARRONNE WARD (PRESIDENT & CEO) |
| Authorized Official Telephone | 7084441012 |
| Is Organization Subpart | N |
| 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 |
|---|---|---|---|---|
| 1154896371 | Grand Prairie Services | Clinic/Center | 747 Red Oak Ln, University Park, IL 60484-2965 | 2018-10-04 |
| 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 |
| Street Address |
19530 KEDZIE AVENUE |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422 |
| 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 |
|---|---|---|---|---|
| 1336158088 | Human Services, Inc. | Clinic/Center | 3235 Vollmer Rd, Suite 119, Flossmoor, IL 60422-2013 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 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.