NPIMap

Organization Active NPI

Mary-Grace, Inc.

  • Case Management Agency
  • Dolton, IL
National Provider Identifier
1801100268
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MARY-GRACE, INC.
Practice address
14446 University Ave
Dolton, IL 60419-1904
Phone
(708) 841-3171
NPI assigned
Jul 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Mr. Durogbayi A. Ogunbameru, MSW
Title
President
Phone
(708) 841-3171

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Psychiatric Residential Treatment Facility 323P00000X

Addresses

Primary practice location

14446 University Ave
Dolton, IL 60419-1904

Mailing address

14446 University Ave
Dolton, IL 60419-1904
Phone (708) 841-3171

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1801100268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14446 UNIVERSITY AVE",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604191904",
            "telephone_number": "708-841-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14446 UNIVERSITY AVE",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604191904",
            "telephone_number": "708-841-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY-GRACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "OGUNBAMERU",
        "authorized_official_first_name": "DUROGBAYI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-841-3171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dolton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.