PRESBYTERIAN HOMES


Address: 1100 Pembridge Drive, Lake Forest, IL 60045
Phone: 8476046700

PRESBYTERIAN HOMES (NPI# 1063472520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063472520
Entity Type Organization
Organization Name PRESBYTERIAN HOMES
Other Organization Name LAKE FOREST PLACE
Practice Address 1100 Pembridge Drive
Lake Forest
IL 60045
Mailing Address 3200 Grant Street
Attn Accounting Department
Evanston
IL 60201
Practice Telephone 8476046700
Practice Fax Number 8475703426
Mailing Telephone 8474924871
Mailing Fax Number 8475703426
Enumeration Date 2006-03-27
Last Update Date 2008-06-04
Authorized Official Name ROBERT E LANDSMAN (VICE PRESIDENT OF FINANCE)
Authorized Official Telephone 8474924859
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 310400000X Assisted Living Facility Nursing & Custodial Care Facilities
N 314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL BLUE CROSS BLUE SHIELD ILLINOIS 04932281 01

Other Provider/Organization Names

Other Name Type Code
Lake Forest Place Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1891765996 Presbyterian Homes Skilled Nursing Facility 811 E Central Rd, Arlington Heights, IL 60005-3244 2006-01-23
1831169945 Presbyterian Homes Assisted Living Facility 1100 Pembridge Dr, Lake Forest, IL 60045 2006-01-23
1700856903 Presbyterian Homes Hospice, Inpatient 3200 Grant Street, Evanston, IL 60201 2006-01-23
1124343157 Presbyterian Homes Assisted Living Facility 3200 Grant St, Evanston, IL 60201-1903 2010-04-01
1033179411 Presbyterian Homes Assisted Living Facility 3200 Grant Street, Evanston, IL 60201 2006-03-28

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities Presbyterian Homes & Family Services Inc. 150 Linden Ave, Lynchburg, Virginia 24503
System for Award Management (SAM) Entities PRESBYTERIAN HOMES & SERVICES 4290 Middle Settlement Rd, New Hartford, NY 13413-5314
New York State Corporations PRESBYTERIAN HOMES & SERVICES, INC. 4290 Middle Settlement Road, P.o. Box 1144, New Hartford, New York 13413
System for Award Management (SAM) Entities PRESBYTERIAN HOMES AND SERVICES 9889 Penn Avenue S, Minneapolis, MN 55431-2912
Washington State Corporations PRESBYTERIAN HOMES AND SERVICES 2845 Hamline Ave N, Roseville, MN 55113-7127
Iowa Business Entities PRESBYTERIAN HOMES AND SERVICES 2845 Hamline Ave N, Roseville, MN 55113
Indiana Business Entities PRESBYTERIAN HOMES AND SERVICES OF KENTUCKY, INC. 4109 Bardstown Rd., Suite C, Louisville, KY 40218
System for Award Management (SAM) Entities PRESBYTERIAN HOMES EAST WINSOR 20 Lanning Blvd Ofc, Hightstown, NJ 08520-1930
Indiana Business Entities PRESBYTERIAN HOMES INC. 1020 Conkey St, Hammond, IN 46320
Iowa Business Entities PRESBYTERIAN HOMES MILL POND, INC. 2845 Hamline Ave. North, St Paul, MN 55113

Office Location

Street Address 1100 PEMBRIDGE DRIVE
City LAKE FOREST
State IL
Zip Code 60045

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NPI Name Taxonomy Address Enumeration
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1013453406 Katie L Konopacz Nurse Practitioner 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 2017-01-10
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City LAKE FOREST
Zip Code 60045

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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