South Central Community Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTH CENTRAL COMMUNITY SERVICES, INC.

Practice address

8316 S Ellis Ave
Chicago, IL 60619-5509

Phone

(773) 483-0900

Fax

(773) 483-8090

NPI assigned

Mar 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Judi Bradley

Title

Chief Financial Officer

Phone

(773) 483-0900

Specialties & licenses 1

Addresses

Tax ID family

South Central Community Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• South Central Community Services, Inc.

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1336470392
  NPD tax ID
• South Central Community Services, Inc.

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1932384039
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1033389432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 S ELLIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195509",
            "telephone_number": "773-483-0900",
            "fax_number": "773-483-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 S ELLIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195509",
            "telephone_number": "773-483-0900",
            "fax_number": "773-483-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "JUDI",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-483-0900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Alexandra Sourelis-Smith, LCSW
• Ghassan Souri, D.D.S.
• Christa Marie Souris, D.M.D.
• Wesam Sourour, MD
• Jacqueline Rose Souter, AU.D.
• South Central Community Services, Inc.
• South Central Community Services, Inc.
• South Chicago Foot & Ankle Center, LTD
• South Chicago Lab Limited
• South Chicago Orthopedic Specialists, SC

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.