| Mfcr | |
|
3330 W 177th St Suite 1-f Hazel Crest IL 60429-2184 | |
| (708) 745-3040 | |
| (708) 799-1889 |
| Full Name | Mfcr |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3330 W 177th St, Hazel Crest, Illinois |
| Authorized Official Name and Position | Robert Emil Thurman (OWNER) |
| Authorized Official Contact | 7736539467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mfcr 3330 W 177th St Ste 1f Hazel Crest IL 60429-2186 Ph: (646) 844-8999 | Mfcr 3330 W 177th St Suite 1-f Hazel Crest IL 60429-2184 Ph: (708) 745-3040 |
| NPI Number | 1770818064 |
|---|---|
| Provider Enumeration Date | 10/05/2009 |
| Last Update Date | 03/16/2026 |
| Certification Date | 03/16/2026 |
| Medicare PECOS PAC ID | 0345381018 |
|---|---|
| Medicare Enrollment ID | O20100104000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770818064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149007763 (Illinois) | Primary |
| Provider Name | Norma K Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326369091 PECOS PAC ID: 7315955358 Enrollment ID: I20060403000045 |
| Provider Name | Kimberly Spivey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245535269 PECOS PAC ID: 0042495848 Enrollment ID: I20110420000644 |
| Provider Name | Lorez a White-banks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831412568 PECOS PAC ID: 3577718873 Enrollment ID: I20130312000090 |
| Provider Name | Susan E Zeitner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174861736 PECOS PAC ID: 7113163080 Enrollment ID: I20130419000153 |
| Provider Name | Vienne Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073916888 PECOS PAC ID: 1951624345 Enrollment ID: I20141215002179 |
| Provider Name | Oladimeji M Kassim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861885675 PECOS PAC ID: 8224341938 Enrollment ID: I20150723007351 |
| Provider Name | Thomas Southerland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447752324 PECOS PAC ID: 0244594240 Enrollment ID: I20180427000347 |
| Provider Name | Antionette Diane Fefee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710484449 PECOS PAC ID: 5193079390 Enrollment ID: I20181106002426 |
| Provider Name | Mudira T Oyewole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659909406 PECOS PAC ID: 9032524178 Enrollment ID: I20210223000893 |
| Provider Name | Jamila M. Oladipo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679108153 PECOS PAC ID: 3779804471 Enrollment ID: I20210828000336 |
| Provider Name | Tomilola Adewolu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063138618 PECOS PAC ID: 2668841537 Enrollment ID: I20221215001909 |
| Provider Name | Gia V Washington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386261360 PECOS PAC ID: 6406296441 Enrollment ID: I20240424003443 |
| Provider Name | Michael N Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003143967 PECOS PAC ID: 6507206208 Enrollment ID: I20240429001764 |
| Provider Name | Margo Roethlisberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194294413 PECOS PAC ID: 9234570789 Enrollment ID: I20240515000391 |
| Provider Name | Lakisha Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306663463 PECOS PAC ID: 0648792747 Enrollment ID: I20250318003171 |
| Provider Name | Latrece Madison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821892464 PECOS PAC ID: 9931681400 Enrollment ID: I20260304001475 |
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