Presence Ambulatory Services

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PRESENCE AMBULATORY SERVICES

Practice address

7230 W North Ave
Suite 106B
Elmwood Park, IL 60707-4261

Phone

(708) 453-3000

Fax

(708) 453-4460

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Melvonne Wickliffe-Jones

Title

Credentialing MGR

Phone

(630) 914-2417

Specialties & licenses 1

Addresses

Other names 1

• Presence Immediate Care - Elmwood Park Doing business as

Locations

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1407182108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604400000",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 W NORTH AVE",
            "address_2": "SUITE 106B",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074261",
            "telephone_number": "708-453-3000",
            "fax_number": "708-453-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE AMBULATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "WICKLIFFE-JONES",
        "authorized_official_first_name": "MELVONNE",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "630-914-2417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence Immediate Care - Elmwood Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seema Pillai, NP
• Cynthia Plazas, PH.D., LCPC
• Alicja B Poleszak, M.D.
• Anthony Orlando Ponzio, D.D.S
• PPD North Avenue LLC
• Presence Ambulatory Services
• Proactive Health Care
• Prosniewski and Papa PC
• Vanessa Przybyla, APN-CNP
• Psychiatric Consultants of Illinois

• Multi-Specialty Clinic/Center in Elmwood Park, IL
• Providers in Elmwood Park, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.