Midwest Family and Community Resources PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MIDWEST FAMILY AND COMMUNITY RESOURCES PC

Practice address

3330 W 177TH St FL 1
Hazel Crest, IL 60429-2184

Phone

(708) 745-3040

Fax

(708) 799-1889

NPI assigned

Oct 9, 2019

Organization subpart

No

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

Authorized official

Name

Robert Emil Thurman, LCSWNPI 1205049194

Title

Owner, LCSW

Phone

(708) 745-3040

Specialties & licenses 2

Addresses

Tax ID family

Midwest Family and Community Resources PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Midwest Family and Community Resources PC

  • Community/Behavioral Health Agency
  • Hazel Crest, IL
  • NPI 1770818064
  NPD tax ID

Locations

Practitioners 2

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

• Robert Emil Thurman Jr., LCSW

  • Clinical Social Worker
  • Hazel Crest, IL
  • NPI 1205049194
  NPD Authorized official
• Kendra Cornett, LCSW

  • Clinical Social Worker
  • Hazel Crest, IL
  • NPI 1467096370
  NPD

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1427690676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST FL 1",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-745-3040",
            "fax_number": "708-799-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST FL 1",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-745-3040",
            "fax_number": "708-799-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FAMILY AND COMMUNITY RESOURCES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "THURMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EMIL",
        "authorized_official_title_or_position": "OWNER, LCSW",
        "authorized_official_telephone_number": "708-745-3040",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Ellis Meyers, MD
• MFMM Inc
• Marjorie Ginou Michel, M.D.
• Midwest Anesthesia and Pain Specialists SC
• Midwest Diagnostics Inc
• Midwest Family and Community Resources PC
• Sandra Lynn Mikulich, APN
• Melanie Doreen Miller, M.A.
• Mindful Expressions PLLC
• Gina M Minga, APRN, ACCNS-BC

• Adolescent and Children Mental Health Clinic/Center in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Adolescent and Children Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.