Tri-Care, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

20020006C Issued in IL

Legal business name

TRI-CARE, INC.

Practice address

9208 S Colfax Ave
Chicago, IL 60617-4029

Phone

(773) 375-6146

Fax

(773) 375-6148

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Denise Porter

Title

Executive Director

Phone

(773) 375-6146

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1942427786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9208 S COLFAX AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174029",
            "telephone_number": "773-375-6146",
            "fax_number": "773-375-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9208 S COLFAX AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174029",
            "telephone_number": "773-375-6146",
            "fax_number": "773-375-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-375-6146",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "20020006C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celeste Marie Trevino, MS LCPC
• Michael Trevino, MD
• Richard R Trezona Jr., PH.D.
• Tri Care Medical Group LLC
• Tri Star Pharmacy Inc
• Christina Marie Tri, MA, LPC
• Samuel David Tri, DO
• Tria Aesthetics & Wellness
• Triad Hospitalist Group SC
• Merilee Trias, PT

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.