Englewood Community Outreach

Primary specialty

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

Legal business name

ENGLEWOOD COMMUNITY OUTREACH

Practice address

8848 S Langley Ave
Chicago, IL 60619-6859

Phone

(872) 209-1298

NPI assigned

Jan 5, 2024

Organization subpart

No

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

Authorized official

Name

Shanta CoppageNPI 1295322287

Title

Executive Director

Phone

(872) 209-1298

Specialties & licenses 5

Addresses

Tax ID family

Englewood Community Outreach2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Englewood Community Outreach

  • Day Training/Habilitation Specialist
  • Evergreen Park, IL
  • NPI 1205666096
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanta Coppage

  • Case Manager/Care Coordinator
  • Chicago, IL
  • NPI 1295322287
  NPD Authorized official

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1811767296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 S CICERO AVE # 1356",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533137",
            "telephone_number": "872-203-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8848 S LANGLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196859",
            "telephone_number": "872-209-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGLEWOOD COMMUNITY OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "COPPAGE",
        "authorized_official_first_name": "SHANTA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "872-209-1298"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlene Englander, MSW
• Engle Developmental Group
• Leslie S Engle
• Kristiana E Engler
• Englewood Community Connection Outreach
• Englewood Dental Care
• Englewood Management Health, S.C.
• Englewood Pediatrics SC
• Englewood RX Pharmacy, Inc.
• Englewood Satellite Senior Center

• 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 Jan 5, 2024; 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.