Ican Dream Center NFP

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ICAN DREAM CENTER NFP

Practice address

17512 E Carriageway Dr
Hazel Crest, IL 60429-2091

Phone

(708) 798-4200

NPI assigned

Apr 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Evisha Ford, LCSWNPI 1720570401

Title

Director

Phone

(708) 307-0440

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evisha Shavonn Ford

  • Clinical Social Worker
  • Tinley Park, IL
  • NPI 1720570401
  NPD Authorized official

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1114415080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17512 E CARRIAGEWAY DR",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292091",
            "telephone_number": "708-798-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17512 E CARRIAGEWAY DR",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292091",
            "telephone_number": "708-798-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAN DREAM CENTER NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "EVISHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-307-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Edward Houston, CADC
• Rama Hritani, MD
• Michael Humble, MASSAGE THERAPIST
• Rayna Lenora Hunt
• Bonita Husband, CRC
• Ijg Transportation L.L.C.
• Syed Haider M Imam
• Imperial Manor of Hazel Crest, LLC
• Imperial of Hazel Crest
• Inter-Community Radiation Oncology SC

• Community/Behavioral Health Agency in Hazel Crest, IL
• Providers in Hazel Crest, 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 Apr 26, 2018; 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.