| Grand Prairie Services | |
|
17746 Oak Park Ave Tinley Park IL 60477-3936 | |
| (708) 444-1012 | |
| (708) 614-9449 |
| Full Name | Grand Prairie Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 17746 Oak Park Ave, Tinley Park, Illinois |
| Authorized Official Name and Position | Sharronne Ward (PRESIDENT & CEO) |
| Authorized Official Contact | 7084441012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Prairie Services 17746 Oak Park Ave Tinley Park IL 60477-3936 Ph: (708) 444-1012 | Grand Prairie Services 17746 Oak Park Ave Tinley Park IL 60477-3936 Ph: (708) 444-1012 |
| NPI Number | 1346304979 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 7517876691 |
|---|---|
| Medicare Enrollment ID | O20041116000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346304979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lambros C Chrones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649265026 PECOS PAC ID: 3971405390 Enrollment ID: I20040124000272 |
| Provider Name | Cynthia C Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043264823 PECOS PAC ID: 4082507785 Enrollment ID: I20040205001139 |
| Provider Name | Mahim K Vora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922085695 PECOS PAC ID: 4587640974 Enrollment ID: I20040626000134 |
| Provider Name | Venkata Jampala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235138579 PECOS PAC ID: 2769458355 Enrollment ID: I20040903001243 |
| Provider Name | Farid Karimi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053407486 PECOS PAC ID: 8527026939 Enrollment ID: I20041230000422 |
| Provider Name | Michael George Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710953070 PECOS PAC ID: 9739194507 Enrollment ID: I20060215000418 |
| Provider Name | Ellen M Haas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306995915 PECOS PAC ID: 5799889440 Enrollment ID: I20070406000020 |
| Provider Name | Morris A Blount |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003912601 PECOS PAC ID: 4284521352 Enrollment ID: I20080611000054 |
| Provider Name | Franchot B Givens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154417632 PECOS PAC ID: 2163567298 Enrollment ID: I20100301000716 |
| Provider Name | Alexander Morrill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932374873 PECOS PAC ID: 0941335152 Enrollment ID: I20100312000719 |
| Provider Name | Renu Gupta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609908383 PECOS PAC ID: 0244424141 Enrollment ID: I20101104001076 |
| Provider Name | Shanta Nair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972598233 PECOS PAC ID: 6406099159 Enrollment ID: I20130827000841 |
| Provider Name | Cheriece R Mcneely |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821447285 PECOS PAC ID: 2668764838 Enrollment ID: I20200428001042 |
| Provider Name | Sharronne Ingrid Ward |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902123516 PECOS PAC ID: 2567627037 Enrollment ID: I20240313002925 |
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