| K.a.m Alliance, Inc. | |
|
2215 W 95th St Ste 100 Chicago IL 60643-1001 | |
| (773) 239-9600 | |
| (773) 239-9601 |
| Full Name | K.a.m Alliance, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2215 W 95th St Ste 100, Chicago, Illinois |
| Authorized Official Name and Position | Angela Johneice Ratcliffe (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 7732399600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K.a.m Alliance, Inc. 2215 W. 95th Street Suite 100 Chicago IL 60643-1001 Ph: (773) 239-9600 | K.a.m Alliance, Inc. 2215 W 95th St Ste 100 Chicago IL 60643-1001 Ph: (773) 239-9600 |
| NPI Number | 1003046152 |
|---|---|
| Provider Enumeration Date | 07/23/2009 |
| Last Update Date | 06/20/2018 |
| Medicare PECOS PAC ID | 7315085289 |
|---|---|
| Medicare Enrollment ID | O20091113000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003046152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Bezalel Dantz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316049026 PECOS PAC ID: 8527961911 Enrollment ID: I20040202000312 |
| Provider Name | Yihoodah Y Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376578005 PECOS PAC ID: 3971579087 Enrollment ID: I20040910000029 |
| Provider Name | Karen D Taylor-crawford |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1255444311 PECOS PAC ID: 1850338930 Enrollment ID: I20050411000540 |
| Provider Name | Andre T Dejean |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639140700 PECOS PAC ID: 6608810130 Enrollment ID: I20050615000990 |
| Provider Name | Carol Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689609554 PECOS PAC ID: 0941200596 Enrollment ID: I20070104000061 |
| Provider Name | Jada J Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104082734 PECOS PAC ID: 7315092707 Enrollment ID: I20090909000166 |
| Provider Name | Willie Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194084095 PECOS PAC ID: 9830414788 Enrollment ID: I20150217001046 |
| Provider Name | Syreeta L Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396066114 PECOS PAC ID: 7719206697 Enrollment ID: I20150427000541 |
| Provider Name | Karin Rawski-rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477927655 PECOS PAC ID: 0446551451 Enrollment ID: I20151216002471 |
| Provider Name | Ibi Jessica Jeremiah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477097962 PECOS PAC ID: 2769735950 Enrollment ID: I20181106001180 |
| Provider Name | Lynetta F Trice-bickham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962987511 PECOS PAC ID: 8325278419 Enrollment ID: I20190109000568 |
| Provider Name | Joy Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578858924 PECOS PAC ID: 1052582905 Enrollment ID: I20200602002591 |
| Provider Name | Alethea C Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518501824 PECOS PAC ID: 8224458971 Enrollment ID: I20201019000597 |
| Provider Name | Ahnawee South |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952936957 PECOS PAC ID: 3870997034 Enrollment ID: I20210810002161 |
| Provider Name | Ewa Zofia Ehrlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134895196 PECOS PAC ID: 7416348198 Enrollment ID: I20220107000530 |
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