Southland Care Coordination Partners, Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SOUTHLAND CARE COORDINATION PARTNERS, INC.

Practice address

600 Holiday Plaza Dr
Matteson, IL 60443-2241

Phone

(708) 996-4002

Fax

(708) 898-0142

NPI assigned

Aug 16, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ann Assam, PHAMD

Title

Treasurer

Phone

(708) 567-2053

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1952957698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOLIDAY PLAZA DR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432241",
            "telephone_number": "708-996-4002",
            "fax_number": "708-898-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOLIDAY PLAZA DR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432241",
            "telephone_number": "708-996-4002",
            "fax_number": "708-898-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND CARE COORDINATION PARTNERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "ASSAM",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "708-567-2053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHAMD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffani Smith, LPC
• Victoria B Smith
• Karen A Sobieraj, MSW LCSW BCD
• Augustine Sohn, LCSW
• Southland Care Coordination Partners, Inc.
• Zoe R Spada, DPT
• Special Care Transportaion
• Kimberly Patrice Spivey, LCSW
• Toni L Spraggins, CMT
• Cylia Rose Srmek

• Family Nurse Practitioner in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.