NPIMap

Organization Active NPI

Healing Hands Resource Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
National Provider Identifier
1790938249
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HEALING HANDS RESOURCE CENTER
Practice address
2128 S Central Park Ave
Chicago, IL 60623-3113
Phone
(773) 467-6967
Fax
(773) 572-9553
NPI assigned
Oct 28, 2008
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 / Exec Director
Phone
(773) 467-6967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 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) 814-3201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131230001502 IL Part B Supplier - Clinic/Group Practice 0143457812 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; Princeton, IL; Streator, IL

National Provider Directory

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

Other organizations with this tax ID 10

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

Locations

2128 S Central Park Ave
Chicago, IL 60623
Phone (773) 814-3201

329 S Ottawa St
Joliet, IL 60436

401 W Bridge St
Streator, IL 61364
Phone (815) 220-0299

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1790938249",
    "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": "773-814-3201",
            "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",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_title_or_position": "CEO / EXEC DIRECTOR",
        "authorized_official_telephone_number": "773-467-6967",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.