PRESENCE HEALTHCARE SERVICES (NPI# 1528359924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528359924 |
| Entity Type | Organization |
| Organization Name | PRESENCE HEALTHCARE SERVICES |
| Other Organization Name | PRESENCE MEDICAL GROUP |
| Practice Address |
1431 North Western Avenue Suite 502 Chicago IL 60622-1797 |
| Mailing Address |
1000 Remington Boulevard Bolingbrook IL 60440-0000 |
| Practice Telephone | 7732782600 |
| Practice Fax Number | 7732782424 |
| Mailing Telephone | 6309142417 |
| Mailing Fax Number | 6309142499 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2013-04-10 |
| Authorized Official Name | MRS. MELVONNE WICKLIFFE-JONES (CREDENTIALING MGR) |
| Authorized Official Telephone | 6309142417 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036051754 | 05 |
| Other Name | Type Code |
|---|---|
| Presence Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043748338 | Presence Healthcare Services | Internal Medicine | 1000 Remington Blvd Ste 100, Bolingbrook, IL 60440-4707 | 2017-05-31 |
| 1356727127 | Presence Healthcare Services | Internal Medicine | 2601 Navistar Dr Fl 2, Lisle, IL 60532-3679 | 2015-08-04 |
| 1295019842 | Presence Healthcare Services | Family Medicine | 3046 N Ashland Ave, Chicago, IL 60657-3034 | 2011-09-30 |
| 1851672224 | Presence Healthcare Services | Internal Medicine | 1792 East Oakton Street, Chicago, IL 60018-2110 | 2011-08-30 |
| 1902198161 | Presence Healthcare Services | Family Medicine | 5251 North Milwaukee Avenue, Chicago, IL 60630-4437 | 2011-05-06 |
| 1699078238 | Presence Healthcare Services | Internal Medicine | 5747 West Dempster Street, Morton Grove, IL 60053-3056 | 2010-12-20 |
| 1760701841 | Presence Healthcare Services | Otolaryngology | 5308 North Belmont Avenue, Chicago, IL 60641-0000 | 2010-05-27 |
| 1841381738 | Presence Healthcare Services | Pharmacy | 100 N. River Road, Suite 122s, Des Plaines, IL 60016-1209 | 2006-09-27 |
| 1932216819 | Presence Healthcare Services | Family Medicine | 2601 Navistar Dr Fl 3, Lisle, IL 60532-3679 | 2006-08-24 |
| 1114201761 | Presence Healthcare Services | Family Medicine | 7447 W Talcott Ave, Suite 551, Chicago, IL 60631-3745 | 2011-09-30 |
| Street Address |
1431 NORTH WESTERN AVENUE SUITE 502 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60622-1797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346529112 | Presence Healthcare Services | Family Medicine | 1431 North Western Avenue, Suite 205, Chicago, IL 60622-1774 | 2011-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447880471 | Erikson Institute | Clinic/Center | 2739 W Division St, Chicago, IL 60622 | 2020-01-17 |
| 1720620545 | Emily Claire Bonanno | Counselor | 1397 N Miwaukee Ave, Chicago, IL 60622 | 2019-10-14 |
| 1891342093 | Taylor Mallon | Speech-Language Pathologist | 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 | 2019-08-22 |
| 1083260277 | Maggie Inman | Student in an Organized Health Care Education/Training Program | 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 | 2019-08-13 |
| 1174176168 | Karol Maricel Quelal Analuisa | Internal Medicine | 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 | 2019-07-19 |
| 1073076105 | Nichole Galullo | Social Worker | 1431 N Claremont 2nd Floor, Chicago, IL 60622 | 2019-04-06 |
| 1003375122 | Alfredo Delgado Perez Sr. | Psychologist | 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 | 2019-03-18 |
| 1841773439 | Abigail Hector | Counselor | 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 | 2018-09-11 |
| 1164916144 | Dorothy Mitkowski | Student in an Organized Health Care Education/Training Program | 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 | 2018-06-21 |
| 1255825121 | Kara Lynn Daniel | Speech-Language Pathologist | 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 | 2018-06-14 |
| Find all providers in zip 60622 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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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.