Place of Restoration

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PLACE OF RESTORATION

Practice address

4332 N Kedzie Ave
1St Floor
Chicago, IL 60618-1302

Phone

(773) 267-5008

NPI assigned

Sep 24, 2009

Organization subpart

Yes

Parent organization

THE LORD'S TABLEAs reported in NPPES

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

Authorized official

Name

Mr. Olumide Oluwole, RN

Title

Director

Phone

(773) 392-1585

Specialties & licenses 1

Addresses

Other names 1

• THE LORD'S TABLE Other name

Part of

Place of Restoration

Locations

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1447584388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 N KEDZIE AVE",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181302",
            "telephone_number": "773-267-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4332 N KEDZIE AVE",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181302",
            "telephone_number": "773-267-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACE OF RESTORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LORD'S TABLE",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "OLUWOLE",
        "authorized_official_first_name": "OLUMIDE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-392-1585",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE LORD'S TABLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gennlie Nichole Pizarro, MD
• Pamela Flores Pizarro
• Giancarlo Pizzino, MD
• Nicholas Joseph Pizzo
• Patricia Pla Castillo, MD
• Stephanie Elizabeth Place, M.D.
• Tamara Placeres, LPC
• Lens Placide, DO
• Placidity Healthcare Incorporated
• Placidity Mindcare PLLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.