CAMELOT CARE CENTERS, LLC (NPI# 1740888205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740888205 |
| Entity Type | Organization |
| Organization Name | CAMELOT CARE CENTERS, LLC |
| Practice Address |
4747 Lincoln Mall Dr Ste 305 Matteson IL 60443-3814 |
| Mailing Address |
333 W Pierce Rd Ste 175 Itasca IL 60143-3120 |
| Practice Telephone | 7087477250 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | RONICA R PATEL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8478497664 |
| Is Organization Subpart | Y |
| Parent Organization Name | PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1831797141 | Camelot Care Centers, LLC | Clinic/Center | 5301 E State St Ste 208, Rockford, IL 61108-2397 | 2020-10-09 |
| 1740510338 | Camelot Care Centers, LLC | Community/Behavioral Health | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2010-01-05 |
| 1710217336 | Camelot Care Centers, LLC | Community/Behavioral Health | 4747 Lincoln Mall Dr Ste 305, Matteson, IL 60443-3814 | 2010-01-04 |
| 1093957300 | Camelot Care Centers, LLC | Community/Behavioral Health | 333 W Pierce Rd, Suite 175, Itasca, IL 60143-3116 | 2009-04-01 |
| 1215535786 | Camelot Care Centers, LLC | Clinic/Center | 2396 W Nebraska Ave, Peoria, IL 61604-3111 | 2020-10-15 |
| 1093313553 | Camelot Care Centers, LLC | Clinic/Center | 333 W Pierce Rd Ste 175, Itasca, IL 60143-3120 | 2020-10-15 |
| 1538767090 | Camelot Care Centers, LLC | Clinic/Center | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2020-10-15 |
| 1700149051 | Camelot Care Centers, LLC | Community/Behavioral Health | 2396 W Nebraska Ave, Peoria, IL 61604-3111 | 2012-06-21 |
| Street Address |
4747 LINCOLN MALL DR STE 305 |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-3814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710217336 | Camelot Care Centers, LLC | Community/Behavioral Health | 4747 Lincoln Mall Dr Ste 305, Matteson, IL 60443-3814 | 2010-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1831797141 | Camelot Care Centers, LLC | Clinic/Center | 5301 E State St Ste 208, Rockford, IL 61108-2397 | 2020-10-09 |
| 1255954780 | The Transformation Specialists LLC | Clinic/Center | 813 Ash St, Flossmoor, IL 60422-2213 | 2020-05-19 |
| 1689296162 | Kmetko & Associates, Ltd. | Clinic/Center | 4043 N Ravenswood Ave Ste 121, Chicago, IL 60613-1176 | 2020-05-07 |
| 1962035709 | Ellen M Griffin Psyd PC | Clinic/Center | 155 N Michigan Ave Ste 512, Chicago, IL 60601-7612 | 2020-02-20 |
| 1962034488 | Global Executive Council Services | Clinic/Center | 5766 N Lincoln Ave Ste 4s, Chicago, IL 60659-4734 | 2020-02-12 |
| 1366082232 | Westcare Illinois, Inc | Clinic/Center | 1100 W Cermak Rd Ste B116, Chicago, IL 60608-4540 | 2020-01-08 |
| 1295379972 | Compass Health Center Oakbrook Pllc | Clinic/Center | 700 Oakmont Ln, Westmont, IL 60559-5551 | 2019-11-05 |
| 1427690676 | Midwest Family and Community Resources PC | Clinic/Center | 3330 W 177th St Fl 1, Hazel Crest, IL 60429-2184 | 2019-10-09 |
| 1720629041 | Monte Nido Illinois, LLC | Clinic/Center | 27w121 80th St, Naperville, IL 60565-1270 | 2019-10-08 |
| 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.