NPIMap

Organization Active NPI

Healing Hands Resource Center Streator

Doing business as Healing Hands Resource Center -- Central Pk

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1720699176
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HEALING HANDS RESOURCE CENTER STREATOR
Doing business as
Healing Hands Resource Center -- Central Pk
Practice address
2128 S Central Park Ave
Chicago, IL 60623-3113
Phone
(773) 467-6967
Fax
(773) 572-9553
NPI assigned
Aug 10, 2020
Last updated
Aug 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALING HANDS RESOURCE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Valencia Green, MD, MPH
Title
Ceo
Phone
(773) 467-6967

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2128 S Central Park Ave
Chicago, IL 60623-3113

Mailing address

1022 N Kedzie Ave
Chicago, IL 60651-4128
Phone (773) 467-6967

Other names 1

  • Healing Hands Resource Center -- Central Pk Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healing Hands Resource Center11 organizations share this tax ID, including this one
Part of
Healing Hands Resource Center

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1720699176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514128",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 S CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233113",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HANDS RESOURCE CENTER STREATOR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALING HANDS RESOURCE CENTER",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-467-6967",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healing Hands Resource Center -- Central Pk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.