Miracle Comprehensive Serivces

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MIRACLE COMPREHENSIVE SERIVCES

Doing business as

MIRACLE COMPREHENSIVE SERVICES

Practice address

4440 Lincoln Hwy Ste 205
Matteson, IL 60443-3803

Phone

(708) 769-1737

NPI assigned

Oct 16, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Eme Udoetuk

Title

Administrator

Phone

(708) 769-1737

Specialties & licenses 1

Addresses

Other names 1

• MIRACLE COMPREHENSIVE SERVICES Doing business as

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1417599945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY STE 205",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433803",
            "telephone_number": "708-769-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY STE 205",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433803",
            "telephone_number": "708-769-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE COMPREHENSIVE SERIVCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "UDOETUK",
        "authorized_official_first_name": "EME",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-769-1737",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIRACLE COMPREHENSIVE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Matteson, IL
• Providers in Matteson, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.