| Chicago Christian Counseling Center Inc | |
|
15127 S 73rd Ave G Orland Park IL 60462-4398 | |
| (708) 845-5500 | |
| (708) 845-5505 |
| Full Name | Chicago Christian Counseling Center Inc |
|---|---|
| Speciality | Social Worker |
| Location | 15127 S 73rd Ave, Orland Park, Illinois |
| Authorized Official Name and Position | Amanda Kuba (BILLING MANAGER) |
| Authorized Official Contact | 7088455500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Christian Counseling Center Inc 15127 S 73rd Ave G Orland Park IL 60462-4398 Ph: (800) 361-6880 | Chicago Christian Counseling Center Inc 15127 S 73rd Ave G Orland Park IL 60462-4398 Ph: (708) 845-5500 |
| NPI Number | 1083664510 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 09/25/2020 |
| Certification Date | 09/25/2020 |
| Medicare PECOS PAC ID | 1052395258 |
|---|---|
| Medicare Enrollment ID | O20040615001668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083664510 | NPI | - | NPPES |
| Provider Name | Nancy C Dawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578796009 PECOS PAC ID: 3476693003 Enrollment ID: I20091211000692 |
| Provider Name | Marilyn J Ciaramitaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194030551 PECOS PAC ID: 9032307418 Enrollment ID: I20101229000694 |
| Provider Name | Douglas Vantil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720359441 PECOS PAC ID: 8820246325 Enrollment ID: I20120906000804 |
| Provider Name | Jessica A Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275812414 PECOS PAC ID: 6800041583 Enrollment ID: I20130301000506 |
| Provider Name | Anne Elizabeth Mirza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568797918 PECOS PAC ID: 5395981526 Enrollment ID: I20130413000100 |
| Provider Name | Laura J Goossens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467833814 PECOS PAC ID: 4981919248 Enrollment ID: I20150814013742 |
| Provider Name | Josephine M Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255796710 PECOS PAC ID: 5890099287 Enrollment ID: I20160204001749 |
| Provider Name | Aimee Echevarria |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366745812 PECOS PAC ID: 9032498027 Enrollment ID: I20161115001611 |
| Provider Name | Shawna M Sapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619356540 PECOS PAC ID: 9436430683 Enrollment ID: I20161229001072 |
| Provider Name | Stephanie M Shelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275072308 PECOS PAC ID: 9931486891 Enrollment ID: I20180103000528 |
| Provider Name | Rachael Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427485952 PECOS PAC ID: 7315287281 Enrollment ID: I20190313001062 |
| Provider Name | Asabi S Yakini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821650672 PECOS PAC ID: 2860728870 Enrollment ID: I20190730000635 |
| Provider Name | Maria R Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699138016 PECOS PAC ID: 7315352739 Enrollment ID: I20210217002047 |
| Provider Name | Jenaya L Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902544463 PECOS PAC ID: 0143601906 Enrollment ID: I20220726000431 |
| Provider Name | Teresa D Patton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699294017 PECOS PAC ID: 4981083359 Enrollment ID: I20230915000251 |
| Provider Name | Julie Twohill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497539746 PECOS PAC ID: 9436504412 Enrollment ID: I20231011001336 |
| Provider Name | Matthew Potter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881904266 PECOS PAC ID: 2062860430 Enrollment ID: I20240116000707 |
| Provider Name | Joyce M Bocanegra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558506766 PECOS PAC ID: 0244688331 Enrollment ID: I20240123003324 |
| Provider Name | Leah Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467229583 PECOS PAC ID: 0547613788 Enrollment ID: I20240124002499 |
| Provider Name | Deborah Mach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558978189 PECOS PAC ID: 9133572829 Enrollment ID: I20240130000688 |
| Provider Name | Vilma R Matthews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871012880 PECOS PAC ID: 6608224076 Enrollment ID: I20240220002086 |
| Provider Name | Linda D Ostlund |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194247957 PECOS PAC ID: 2264881754 Enrollment ID: I20240228000661 |
| Provider Name | Kim T Pronoitis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942517768 PECOS PAC ID: 7810332889 Enrollment ID: I20240229001165 |
| Provider Name | Tanisha Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538712294 PECOS PAC ID: 0840635702 Enrollment ID: I20240314000407 |
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