Organization Active NPI

Integral Health and Community Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1952167025
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
INTEGRAL HEALTH AND COMMUNITY SERVICES LLC
Practice address
9730 S Western Ave
Evergreen Park, IL 60805-2814
Phone
(773) 317-1612
NPI assigned
Feb 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Oladimeji KassimNPI 1861885675
Title
Owner
Phone
(773) 317-1612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9730 S Western Ave
Evergreen Park, IL 60805-2814

Mailing address

15618 New England Ave
Oak Forest, IL 60452-1591

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1952167025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15618 NEW ENGLAND AVE",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052814",
            "telephone_number": "773-317-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL HEALTH AND COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "KASSIM",
        "authorized_official_first_name": "OLADIMEJI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-317-1612"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.