COUNTRYSIDE CARE CENTRE LP (NPI# 1063498285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063498285 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE CARE CENTRE LP |
| Practice Address |
2330 W Galena Blvd Aurora IL 60506-4246 |
| Practice Telephone | 6308964686 |
| Practice Fax Number | 6308967868 |
| Mailing Telephone | 6308964686 |
| Mailing Fax Number | 6308967868 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2012-02-20 |
| Authorized Official Name | MR. MICHAEL CHARLES BRAUN (CONTROLLER) |
| Authorized Official Telephone | 8475830100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 40931 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IDPH LICENSE NUMBER | 40931 | 01 |
| IL | IDPH FACILITY NUMBER | 6002174 | 01 |
| Street Address |
2330 W GALENA BLVD |
| City | AURORA |
| State | IL |
| Zip Code | 60506-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387993 | Robert Conard | Speech-Language Pathologist | 2330 W Galena Blvd, Aurora, IL 60506-4246 | 2020-08-18 |
| 1013560671 | Megan J. Schaaf | Social Worker | 2330 W Galena Blvd, Aurora, IL 60506-4246 | 2019-07-22 |
| 1497022743 | Symphony Countryside LLC | Skilled Nursing Facility | 2330 W Galena Blvd, Aurora, IL 60506-4246 | 2011-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678121 | Yvette Velazquez | Non-emergency Medical Transport (VAN) | 1743 Plum St, Aurora, IL 60506 | 2020-01-09 |
| 1609420173 | Salma Hydari | Dentist | 1264 N Lake St., Aurora, IL 60506 | 2019-08-01 |
| 1720647092 | Tirumala Aggarwal | Dentist | Premier Dental, 1264 N Lake Street, Aurora, IL 60506 | 2019-06-11 |
| 1730644410 | Margaret Elizabeth Beallis | Counselor | 120 Gale St., Aurora, IL 60506 | 2019-02-06 |
| 1639634322 | Jordan Devera | Student in an Organized Health Care Education/Training Program | Aurora University 347 S Gladstone Ave, Pmb 729, Aurora, IL 60506 | 2019-02-06 |
| 1770077737 | Harriet L Miller | Registered Nurse | 1081 Emerald Dr, Aurora, IL 60506 | 2018-06-21 |
| 1275033516 | Lillian Antonia Villamil | Registered Nurse | 400 Mercy Lane, Aurora, IL 60506 | 2018-02-13 |
| 1689173676 | Ideal Medical Equipment and Supplies | Durable Medical Equipment & Medical Supplies | 1177 N Highland Ave Ste#204, Aurora, IL 60506 | 2018-02-06 |
| 1417465535 | Aaron Downing | Counselor | 525 N. Edgelawn Ave, Aurora, IL 60506 | 2018-01-11 |
| 1942739222 | Jessica Toma | Pharmacist | 1952 W Galena Blvd, Aurora, IL 60506 | 2017-06-08 |
| Find all providers in zip 60506 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1063935369 | Quality Care Solutions, L.L.C. | Skilled Nursing Facility | 1313 1st St, Aurora, NE 68818 | 2017-07-19 |
| 1891247714 | Aurora /transitional /care, LLC | Skilled Nursing Facility | 13525 E 23rd Ave, Aurora, CO 80045 | 2016-10-26 |
| 1205234622 | Progressive Aurora LLC | Skilled Nursing Facility | 425 S Chillicothe Rd, Aurora, OH 44202-6548 | 2014-12-17 |
| 1376706010 | Jennings Terrace | Skilled Nursing Facility | 275 S. Lasalle Street, Aurora, IL 60505 | 2008-07-02 |
| 1528288966 | Ahc of Aurora, LLC | Skilled Nursing Facility | 1800 S. Potomac, Aurora, CO 80012-5430 | 2007-04-26 |
| 1821212739 | Fox River Pavilion Limited Partnership | Skilled Nursing Facility | 400 E New York St, Aurora, IL 60505-3425 | 2007-04-12 |
| 1508931536 | State of Colorado | Skilled Nursing Facility | 1919 Quentin Street, Aurora, CO 80045 | 2006-11-22 |
| 1447350491 | Aurora Manor Limited Partnership | Skilled Nursing Facility | 101 S Bissell Rd, Aurora, OH 44202-9170 | 2006-09-22 |
| 1083710883 | Elmwood Terrace Healthcare Inc | Skilled Nursing Facility | 1017 W Galena Blvd, Aurora, IL 60506-3753 | 2006-09-16 |
| Find all providers in AURORA | ||||
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| 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.