Michelle Elizabeth Churchey-Mims, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

13136 Western Ave
Blue Island, IL 60406-2423

Phone

(708) 974-5856

Fax

(312) 829-0710

NPI assigned

Mar 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295859577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 LEWIS ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061717",
            "telephone_number": "708-385-2079",
            "fax_number": "312-829-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13136 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062423",
            "telephone_number": "708-974-5856",
            "fax_number": "312-829-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHEY-MIMS",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bai Fan Chen, MD
• Jean Chenoweth, P.T.A.
• Belinda Childs
• Vane Swetah Chockalingam Senthilvel, BDS
• Lee R Christensen, M.D.
• Aubrey Lynn Ciesiun
• City of Blue Island (Blue Island Fire Department)
• Catherine Clark, SLP
• Julisa Clark
• Colten Dean Coffin, MA, LCSW

• Professional Counselor in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.