Woodson Center for Adult Healthcare SC

Primary specialty

SpecialistTaxonomy code 174400000X

License

036076317 Issued in IL

Legal business name

WOODSON CENTER FOR ADULT HEALTHCARE SC

Practice address

316 Dixie Hwy
Chicago Heights, IL 60411-1770

Phone

(708) 709-9200

Fax

(708) 756-0348

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Lynnette McRoy

Title

Billing Coordinator

Phone

(773) 767-3822

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1093721219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1097",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "604991097",
            "telephone_number": "708-709-9200",
            "fax_number": "708-756-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111770",
            "telephone_number": "708-709-9200",
            "fax_number": "708-756-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSON CENTER FOR ADULT HEALTHCARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "MCROY",
        "authorized_official_first_name": "LYNNETTE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "773-767-3822"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036076317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076317",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "01626967",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mychole Willis, SSP
• Tashae Wilson
• Windy City Medical Supply Inc.
• With Grace Counseling and Consulting International, PLLC
• Rebecca Lou Wolfe, RNFNPAPN
• Cheryl E Woodson, M.D.
• Bethany J Woodyatt, OT
• Gail Ann Wright, COTA/L
• Young Path Counseling
• Briana N Young, MD

• Specialist in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.