NPIMap

Organization Active NPI

Grand Prairie Services

  • Family Medicine Physician
  • Chicago Heights, IL
National Provider Identifier
1629550892
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRAND PRAIRIE SERVICES
Practice address
450 W 14TH St
Chicago Heights, IL 60411-2463
Phone
(708) 985-3040
Fax
(708) 474-8144
NPI assigned
Sep 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Sharronne Ward
Title
President and Ceo
Phone
(708) 444-1012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

450 W 14TH St
Chicago Heights, IL 60411-2463

Mailing address

17746 Oak Park Ave
Tinley Park, IL 60477-3936
Phone (708) 444-1012

National Provider Directory

National Provider Directory
Tax ID family
Grand Prairie Services21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1629550892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17746 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773936",
            "telephone_number": "708-444-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W 14TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112463",
            "telephone_number": "708-985-3040",
            "fax_number": "708-474-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "SHARRONNE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "708-444-1012"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.