Proactive Community Services

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

PROACTIVE COMMUNITY SERVICES

Practice address

19740 Governors Hwy Ste 118
Flossmoor, IL 60422-2085

Phone

(708) 248-6166

Fax

(866) 298-7558

NPI assigned

Oct 31, 2017

Organization subpart

No

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

Authorized official

Name

Eula Burge

Title

C.E.O/Executive Director

Phone

(708) 248-6166

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1174035059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19740 GOVERNORS HWY STE 118",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222085",
            "telephone_number": "708-248-6166",
            "fax_number": "866-298-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19740 GOVERNORS HWY STE 118",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222085",
            "telephone_number": "708-248-6166",
            "fax_number": "866-298-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "BURGE",
        "authorized_official_first_name": "EULA",
        "authorized_official_title_or_position": "C.E.O/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-248-6166"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Flossmoor, IL by specialty
• Community Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.