| Howard Brown Health Center | |
|
4025 N Sheridan Rd Chicago IL 60613 | |
| (773) 388-1600 | |
| (773) 388-1602 |
| Full Name | Howard Brown Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4025 N Sheridan Rd, Chicago, Illinois |
| Authorized Official Name and Position | Burgundy Johnson (CREDENTIALING) |
| Authorized Official Contact | 8726293491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard Brown Health Center 4025 N Sheridan Rd Chicago IL 60613-2010 Ph: (773) 388-1600 | Howard Brown Health Center 4025 N Sheridan Rd Chicago IL 60613 Ph: (773) 388-1600 |
| NPI Number | 1306048632 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 06/29/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 1052203155 |
|---|---|
| Medicare Enrollment ID | O20040325000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306048632 | NPI | - | NPPES |
| 30411 | Other | IL | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 30411 (Illinois) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Steven L Weinstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124195599 PECOS PAC ID: 0244137412 Enrollment ID: I20031216000427 |
| Provider Name | Catherine M Creticos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356370233 PECOS PAC ID: 8729974753 Enrollment ID: I20040225001076 |
| Provider Name | Zyra D Gordon Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356459432 PECOS PAC ID: 1658362157 Enrollment ID: I20040522000296 |
| Provider Name | Lisa Dorsey Bornfreedom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427298116 PECOS PAC ID: 6002876430 Enrollment ID: I20041012000128 |
| Provider Name | David Max Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942261524 PECOS PAC ID: 6204892581 Enrollment ID: I20041209000213 |
| Provider Name | David Alan Brandt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629004965 PECOS PAC ID: 8628023207 Enrollment ID: I20050316000666 |
| Provider Name | Gary Gerard Bucher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770664856 PECOS PAC ID: 6608810247 Enrollment ID: I20050615000222 |
| Provider Name | Gregory S Rauch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912921297 PECOS PAC ID: 0345285292 Enrollment ID: I20050622000470 |
| Provider Name | Chris Odess Costas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992732630 PECOS PAC ID: 6800890328 Enrollment ID: I20060914000052 |
| Provider Name | Romina A Kee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326077579 PECOS PAC ID: 5294731659 Enrollment ID: I20061010000012 |
| Provider Name | Corinne M Blum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699791400 PECOS PAC ID: 7911903901 Enrollment ID: I20061016000072 |
| Provider Name | Monica A Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912914490 PECOS PAC ID: 1456459908 Enrollment ID: I20070606000422 |
| Provider Name | John A Schneider |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1396868147 PECOS PAC ID: 7618078858 Enrollment ID: I20070718000574 |
| Provider Name | Magda M Houlberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497925861 PECOS PAC ID: 0244306165 Enrollment ID: I20080829000090 |
| Provider Name | Lester E Lamee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104058221 PECOS PAC ID: 5294881504 Enrollment ID: I20090928000523 |
| Provider Name | Alfred K Torrence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225168115 PECOS PAC ID: 6002958436 Enrollment ID: I20100125000057 |
| Provider Name | Robert Todd Hargan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962591404 PECOS PAC ID: 8729114012 Enrollment ID: I20100325000568 |
| Provider Name | Eric D Christoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245287317 PECOS PAC ID: 3476677063 Enrollment ID: I20100903000196 |
| Provider Name | Bonnie William Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851321467 PECOS PAC ID: 2163603341 Enrollment ID: I20110221000956 |
| Provider Name | Sara E Flanagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336475565 PECOS PAC ID: 9638353451 Enrollment ID: I20110401000697 |
| Provider Name | Gregory Brian Winstead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134242159 PECOS PAC ID: 0648429936 Enrollment ID: I20121002000115 |
| Provider Name | Maya Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891952818 PECOS PAC ID: 0446403976 Enrollment ID: I20130114000294 |
| Provider Name | Michelle Evers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619211786 PECOS PAC ID: 6507003712 Enrollment ID: I20130507000657 |
| Provider Name | Lucas B Swenink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609212802 PECOS PAC ID: 2668612029 Enrollment ID: I20130708000318 |
| Provider Name | Kathya M Chartre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174831168 PECOS PAC ID: 2961644554 Enrollment ID: I20130812000082 |
| Provider Name | Andrew Marcos I Altiveros |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326354838 PECOS PAC ID: 2668615436 Enrollment ID: I20130826000949 |
| Provider Name | Kelly M Ducheny |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518173244 PECOS PAC ID: 4385887157 Enrollment ID: I20130826000962 |
| Provider Name | Patrick Gibbons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619282233 PECOS PAC ID: 5890921126 Enrollment ID: I20131115000448 |
| Provider Name | John J Stryker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427281336 PECOS PAC ID: 0648406637 Enrollment ID: I20131121001296 |
| Provider Name | Andrea M Stein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972830602 PECOS PAC ID: 0143450924 Enrollment ID: I20140221000959 |
| Provider Name | Erica J Gaddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609205657 PECOS PAC ID: 0244460855 Enrollment ID: I20140227000808 |
| Provider Name | Mateo Betanzos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457767998 PECOS PAC ID: 4486871050 Enrollment ID: I20140806000984 |
| Provider Name | Cory Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912167818 PECOS PAC ID: 5890967467 Enrollment ID: I20140904001519 |
| Provider Name | Melissa B English Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053671156 PECOS PAC ID: 8123340494 Enrollment ID: I20141124001472 |
| Provider Name | Kathryn S Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235535790 PECOS PAC ID: 1951625516 Enrollment ID: I20150130001385 |
| Provider Name | Kristin K Reitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750635793 PECOS PAC ID: 3274858394 Enrollment ID: I20150213000014 |
| Provider Name | Amy Ruth Sheffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598156705 PECOS PAC ID: 2668522517 Enrollment ID: I20150602001538 |
| Provider Name | Aniruddha Hazra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669736021 PECOS PAC ID: 5294040341 Enrollment ID: I20150818005625 |
| Provider Name | Maricela Garcia |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184955866 PECOS PAC ID: 4284944844 Enrollment ID: I20151110003019 |
| Provider Name | Gary R Fernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265797021 PECOS PAC ID: 5890095004 Enrollment ID: I20151119001617 |
| Provider Name | Andrew Delisle Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144639527 PECOS PAC ID: 4082914536 Enrollment ID: I20151204002143 |
| Provider Name | Donald W Mason |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1427421346 PECOS PAC ID: 8426359779 Enrollment ID: I20160113000714 |
| Provider Name | Kendrick Terrill Clack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730597659 PECOS PAC ID: 8527379221 Enrollment ID: I20160208000909 |
| Provider Name | Daniel Kenneth Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740649243 PECOS PAC ID: 8426353582 Enrollment ID: I20160226001711 |
| Provider Name | Rick D Mcewan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558736736 PECOS PAC ID: 5294031738 Enrollment ID: I20160310000235 |
| Provider Name | Hugh L Cole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346681350 PECOS PAC ID: 8426356122 Enrollment ID: I20160413001493 |
| Provider Name | Jemia Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023475142 PECOS PAC ID: 0941592505 Enrollment ID: I20160630001103 |
| Provider Name | Lisa K Simons |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649475377 PECOS PAC ID: 9931369030 Enrollment ID: I20160713000452 |
| Provider Name | Darcie C Mcdonaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730578964 PECOS PAC ID: 6204153885 Enrollment ID: I20160718000378 |
| Provider Name | Graham Mcmahon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275512477 PECOS PAC ID: 9537122890 Enrollment ID: I20160808002449 |
| Provider Name | Josh Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184166001 PECOS PAC ID: 6800176363 Enrollment ID: I20161130000098 |
| Provider Name | Michelle E Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043769268 PECOS PAC ID: 4880974344 Enrollment ID: I20161130000148 |
| Provider Name | Laura E Craig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588007744 PECOS PAC ID: 0840590808 Enrollment ID: I20170119000438 |
| Provider Name | Kathleen Masella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043752918 PECOS PAC ID: 5092090647 Enrollment ID: I20170321002636 |
| Provider Name | Stanley A Ruder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477099935 PECOS PAC ID: 2769767391 Enrollment ID: I20170322002807 |
| Provider Name | Joseph T Metler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922461680 PECOS PAC ID: 4183991847 Enrollment ID: I20170531000056 |
| Provider Name | Jenna L Wimmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902058035 PECOS PAC ID: 6103966429 Enrollment ID: I20170613002204 |
| Provider Name | She Zhao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508272964 PECOS PAC ID: 9133446248 Enrollment ID: I20170719000857 |
| Provider Name | Jenna M Rawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669761441 PECOS PAC ID: 5991014755 Enrollment ID: I20170720002441 |
| Provider Name | Caitlin Grace Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447770060 PECOS PAC ID: 4880966902 Enrollment ID: I20170823003304 |
| Provider Name | Jonathan Cone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710204706 PECOS PAC ID: 1254565617 Enrollment ID: I20170824002418 |
| Provider Name | Katherine Duffy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881012433 PECOS PAC ID: 4385927904 Enrollment ID: I20170928001655 |
| Provider Name | Andrew M Guzman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417368226 PECOS PAC ID: 3779888599 Enrollment ID: I20171027001327 |
| Provider Name | Hayley Marie Daunis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215251624 PECOS PAC ID: 9234495581 Enrollment ID: I20171102002002 |
| Provider Name | India R Willis-jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518476688 PECOS PAC ID: 7719245190 Enrollment ID: I20171212000942 |
| Provider Name | Robin Rochelle Gay |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1548461940 PECOS PAC ID: 8527389576 Enrollment ID: I20180104000183 |
| Provider Name | Sara Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558878439 PECOS PAC ID: 9133488216 Enrollment ID: I20180118000026 |
| Provider Name | Mary Katharine Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407264187 PECOS PAC ID: 9931469970 Enrollment ID: I20180212002074 |
| Provider Name | Lindsey Elizabeth Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629575238 PECOS PAC ID: 2365706405 Enrollment ID: I20180426000486 |
| Provider Name | Alissa A Catiis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174838577 PECOS PAC ID: 7315292919 Enrollment ID: I20180622001595 |
| Provider Name | Crystal Shelly Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528559424 PECOS PAC ID: 6800141417 Enrollment ID: I20180622002236 |
| Provider Name | Angela Eakels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659863843 PECOS PAC ID: 3173878501 Enrollment ID: I20180626001192 |
| Provider Name | Catherine S Dezynski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932409489 PECOS PAC ID: 6709001936 Enrollment ID: I20180709001517 |
| Provider Name | Thomas S Doctor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871847483 PECOS PAC ID: 1759639883 Enrollment ID: I20180807001779 |
| Provider Name | Rachel Cheeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053836106 PECOS PAC ID: 0244582088 Enrollment ID: I20181006000004 |
| Provider Name | Janet P Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427560119 PECOS PAC ID: 7810241080 Enrollment ID: I20181107002105 |
| Provider Name | Gretchen Louise Kemner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598234726 PECOS PAC ID: 2062756794 Enrollment ID: I20181206000018 |
| Provider Name | Kyle A Mckinley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336699255 PECOS PAC ID: 3476836743 Enrollment ID: I20190118000011 |
| Provider Name | Krista Leigh Yank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780142919 PECOS PAC ID: 9436499456 Enrollment ID: I20190328001780 |
| Provider Name | Lauren Rebecca Koby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003374521 PECOS PAC ID: 3173865920 Enrollment ID: I20190429000765 |
| Provider Name | Tristan Mcpherson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740546779 PECOS PAC ID: 9931402443 Enrollment ID: I20190528000508 |
| Provider Name | Brandi Monique Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568853984 PECOS PAC ID: 3476853375 Enrollment ID: I20190703001564 |
| Provider Name | Queennorah Anigbogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962060566 PECOS PAC ID: 0042545022 Enrollment ID: I20190712001822 |
| Provider Name | H Kinton Rossman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043592892 PECOS PAC ID: 2264767284 Enrollment ID: I20190715000165 |
| Provider Name | Dominique Yvette Murry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538675699 PECOS PAC ID: 7012242886 Enrollment ID: I20190716002433 |
| Provider Name | Juan Ernesto Romero Gaddi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750761359 PECOS PAC ID: 1658684980 Enrollment ID: I20190830001095 |
| Provider Name | Jade Veronica Pagkas-bather |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1831533959 PECOS PAC ID: 5991035180 Enrollment ID: I20191002000525 |
| Provider Name | Liz Franco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992354195 PECOS PAC ID: 3577894500 Enrollment ID: I20191007000207 |
| Provider Name | Nakia Monique Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508425083 PECOS PAC ID: 4688905631 Enrollment ID: I20191007001054 |
| Provider Name | Chandra A Matteson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093360653 PECOS PAC ID: 5799016549 Enrollment ID: I20191009003040 |
| Provider Name | Lauren A Sabbath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184199531 PECOS PAC ID: 6800128174 Enrollment ID: I20191106001557 |
| Provider Name | Robert J Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336790310 PECOS PAC ID: 2769814185 Enrollment ID: I20191122001391 |
| Provider Name | Janis D Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154799799 PECOS PAC ID: 3476987744 Enrollment ID: I20191218003104 |
| Provider Name | Beno Stephen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871050856 PECOS PAC ID: 3476984014 Enrollment ID: I20200514000865 |
| Provider Name | Dawn Marie Bangert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275154080 PECOS PAC ID: 5092146555 Enrollment ID: I20200518000031 |
| Provider Name | Meredith Leigh Berlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548800105 PECOS PAC ID: 8123449832 Enrollment ID: I20200605000028 |
| Provider Name | Michael E. Fanelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770106965 PECOS PAC ID: 4880013143 Enrollment ID: I20201006001803 |
| Provider Name | Shadae Booker-shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306475488 PECOS PAC ID: 1658790928 Enrollment ID: I20201006002033 |
| Provider Name | Christina Mary Schaefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992306211 PECOS PAC ID: 1658782743 Enrollment ID: I20201120001231 |
| Provider Name | Adam Liparoto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912556762 PECOS PAC ID: 5496168593 Enrollment ID: I20210111000702 |
| Provider Name | Bethany Ann Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811281348 PECOS PAC ID: 6901210681 Enrollment ID: I20210121001649 |
| Provider Name | Sara Beth Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992287338 PECOS PAC ID: 9739593377 Enrollment ID: I20210122001064 |
| Provider Name | Ellen Han Nathanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417398777 PECOS PAC ID: 3274756242 Enrollment ID: I20210210000929 |
| Provider Name | Rachael K Goins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306435862 PECOS PAC ID: 8527473255 Enrollment ID: I20210210002537 |
| Provider Name | Belinda Joyce Stiles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457604985 PECOS PAC ID: 0446493084 Enrollment ID: I20210308000669 |
| Provider Name | Elora L Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477130599 PECOS PAC ID: 7911315338 Enrollment ID: I20210422002447 |
| Provider Name | Carolle M Derradji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265033385 PECOS PAC ID: 8527476811 Enrollment ID: I20210427001247 |
| Provider Name | Sarah Hire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053667949 PECOS PAC ID: 9638588304 Enrollment ID: I20210510001217 |
| Provider Name | Caleb Manuel Reyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356872949 PECOS PAC ID: 8325370851 Enrollment ID: I20210623003709 |
| Provider Name | Donna Tanisha Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457918385 PECOS PAC ID: 1052712148 Enrollment ID: I20210628000428 |
| Provider Name | Francesco Tani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851884522 PECOS PAC ID: 5698177525 Enrollment ID: I20210714001719 |
| Provider Name | Olatokunbo Adegboro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093100893 PECOS PAC ID: 8820340805 Enrollment ID: I20210805000048 |
| Provider Name | Kenji Kuramitsu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013588698 PECOS PAC ID: 0244634400 Enrollment ID: I20210810002111 |
| Provider Name | Zachary James Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669977104 PECOS PAC ID: 4284038100 Enrollment ID: I20210813001197 |
| Provider Name | Emily Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063956365 PECOS PAC ID: 2365847654 Enrollment ID: I20210825001181 |
| Provider Name | Karen Marie Rottler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043517253 PECOS PAC ID: 3870742786 Enrollment ID: I20210825003640 |
| Provider Name | Archana Sood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437825825 PECOS PAC ID: 5092110288 Enrollment ID: I20210826001284 |
| Provider Name | Nadine Salman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598281487 PECOS PAC ID: 7810258639 Enrollment ID: I20210930000020 |
| Provider Name | Colin M Haley |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1487846234 PECOS PAC ID: 5294133138 Enrollment ID: I20211007001948 |
| Provider Name | Teofilo N Limosnero |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1386867208 PECOS PAC ID: 1254651581 Enrollment ID: I20211007003641 |
| Provider Name | Kunal Bakshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033591037 PECOS PAC ID: 3375847098 Enrollment ID: I20211012002221 |
| Provider Name | Toni O Elugbadebo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447636808 PECOS PAC ID: 6608184619 Enrollment ID: I20211026001482 |
| Provider Name | Howard Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710951694 PECOS PAC ID: 4284795287 Enrollment ID: I20211026001533 |
| Provider Name | Sarah Eva Schwarzschild |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992355317 PECOS PAC ID: 2163754847 Enrollment ID: I20211101000997 |
| Provider Name | Benjamin Sostrin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588172746 PECOS PAC ID: 1951799477 Enrollment ID: I20211102001168 |
| Provider Name | Martin J Gorbien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477502714 PECOS PAC ID: 7618867938 Enrollment ID: I20211112001112 |
| Provider Name | Aishah Asma Yanssaneh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417485525 PECOS PAC ID: 4385912682 Enrollment ID: I20211118001093 |
| Provider Name | Afshan Husain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205368289 PECOS PAC ID: 9638583156 Enrollment ID: I20211229001580 |
| Provider Name | Christina M Brakebill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992133607 PECOS PAC ID: 7416184536 Enrollment ID: I20220113002123 |
| Provider Name | Guadalupe Quintana-salgado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992389928 PECOS PAC ID: 2769877661 Enrollment ID: I20220310002838 |
| Provider Name | Torrence Vazquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255073961 PECOS PAC ID: 5597152132 Enrollment ID: I20220428001429 |
| Provider Name | Kiera Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033851134 PECOS PAC ID: 4183011794 Enrollment ID: I20220429001316 |
| Provider Name | Lisahira Santoyo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902554025 PECOS PAC ID: 0840677803 Enrollment ID: I20220512000422 |
| Provider Name | Michael Chamberlain |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356922561 PECOS PAC ID: 8426435959 Enrollment ID: I20220521000336 |
| Provider Name | Kaitlyn Flynn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740949916 PECOS PAC ID: 4587043245 Enrollment ID: I20220627001452 |
| Provider Name | John B Wickham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235879990 PECOS PAC ID: 9638558299 Enrollment ID: I20220628002207 |
| Provider Name | Wren W Logan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982139705 PECOS PAC ID: 2365712379 Enrollment ID: I20220719001045 |
| Provider Name | Marc Rosenthal |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992794598 PECOS PAC ID: 1557320645 Enrollment ID: I20220822003545 |
| Provider Name | Travis Mark Amengual |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386147163 PECOS PAC ID: 3971849829 Enrollment ID: I20220829001019 |
| Provider Name | Daniel W Au |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992906309 PECOS PAC ID: 0244614535 Enrollment ID: I20220906002419 |
| Provider Name | Summer Kee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013592740 PECOS PAC ID: 8426433715 Enrollment ID: I20220922003046 |
| Provider Name | Samantha Lin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538756440 PECOS PAC ID: 1557764065 Enrollment ID: I20221019000132 |
| Provider Name | Femmily Blake Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871096016 PECOS PAC ID: 6204203599 Enrollment ID: I20221028001885 |
| Provider Name | Juba Watts-cain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255997516 PECOS PAC ID: 5193192367 Enrollment ID: I20221031002556 |
| Provider Name | Jeanne Marie Vega-byrnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871161802 PECOS PAC ID: 0143606574 Enrollment ID: I20221123002664 |
| Provider Name | Lance E Leslie |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346974581 PECOS PAC ID: 0345619573 Enrollment ID: I20221212000473 |
| Provider Name | Angela Yecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487379244 PECOS PAC ID: 8022488337 Enrollment ID: I20230103000981 |
| Provider Name | Leanna Lyn Gordon |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1689012742 PECOS PAC ID: 0648640821 Enrollment ID: I20230104001444 |
| Provider Name | Valeria Lazo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295216133 PECOS PAC ID: 1456722305 Enrollment ID: I20230201000340 |
| Provider Name | Nicole E Noonan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740955749 PECOS PAC ID: 5597137489 Enrollment ID: I20230201002736 |
| Provider Name | Casey May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093422057 PECOS PAC ID: 5193197721 Enrollment ID: I20230208001992 |
| Provider Name | Sam Clubb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174230130 PECOS PAC ID: 3577937705 Enrollment ID: I20230329002699 |
| Provider Name | Joseph Powers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1679066195 PECOS PAC ID: 4385002971 Enrollment ID: I20230613003698 |
| Provider Name | Soumya Ann Thomas |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1881181329 PECOS PAC ID: 1850753997 Enrollment ID: I20230822000448 |
| Provider Name | Onel I Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437509569 PECOS PAC ID: 7618203266 Enrollment ID: I20230907003598 |
| Provider Name | Tyrone Landingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326727827 PECOS PAC ID: 4486000916 Enrollment ID: I20231019002053 |
| Provider Name | Bianca Jenkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568099380 PECOS PAC ID: 6800242439 Enrollment ID: I20231102000288 |
| Provider Name | Vanessa Camacho |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386322014 PECOS PAC ID: 5890143580 Enrollment ID: I20231117001996 |
| Provider Name | Mariana Olga Cisneros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801660964 PECOS PAC ID: 7315395944 Enrollment ID: I20231121000931 |
| Provider Name | David Nolin Maclin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1871711747 PECOS PAC ID: 5193014173 Enrollment ID: I20240110002129 |
| Provider Name | Milton Aguilar Dos Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487423281 PECOS PAC ID: 5890148043 Enrollment ID: I20240124002994 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |