WILKINSON FOUNTAINS LEASE CO LLC (NPI# 1194920058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194920058 |
| Entity Type | Organization |
| Organization Name | WILKINSON FOUNTAINS LEASE CO LLC |
| Other Organization Name | THE FOUNTAINS OF SHILOH |
| Practice Address |
1201 Hartman Ln Belleville IL 62221-8402 |
| Mailing Address |
78 Centennial Loop Eugene OR 97401-7900 |
| Practice Telephone | 6082399282 |
| Practice Fax Number | 6182229305 |
| Mailing Telephone | 5417473373 |
| Mailing Fax Number | 5417470673 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | MR. JOHN HOLTZ (CONTROLLER) |
| Authorized Official Telephone | 5417473373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| THE FOUNTAINS OF SHILOH | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356546212 | Wilkinson Fountains Lease Co LLC | Point of Service | 39 Dorothy Dr, Troy, IL 62294-1389 | 2007-06-19 |
| Street Address |
1201 HARTMAN LN |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62221-8402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255681888 | Joann Dawn Mix | Physical Therapist | 1201 Hartman Ln, Belleville, IL 62221-8402 | 2012-09-11 |
| 1770880148 | Holly Keller | Occupational Therapist | 1201 Hartman Ln, Belleville, IL 62221-8402 | 2011-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679134829 | Dr. Cynthia C. Banderet, Dmd, PC | Clinic/Center | 2630 Mascoutah Ave., Suite A, Belleville, IL 62221 | 2019-06-27 |
| 1942763487 | John Joseph Oldani | Psychologist | Bassc - Belleville Area Special Services Cooperative, 2411 Pathways Crossing, Belleville, IL 62221 | 2019-04-11 |
| 1114497781 | Kendra D Edwards | Counselor | 900 Royal Height Rd Suite 2150, Belleville, IL 62221 | 2018-11-27 |
| 1326537358 | Barbara S Laidlaw | Counselor | 2362 Country Rd, Belleville, IL 62221 | 2018-05-04 |
| 1083133946 | Kierra Jackson | In Home Supportive Care | 2611 Sierra Drive Apt. F, Belleville, IL 62221 | 2017-09-12 |
| 1972022994 | Kathleen Denise Defranco | Speech-Language Pathologist | 2028 Lebanon Ave., Belleville, IL 62221 | 2017-09-11 |
| 1700302270 | Mark Hofelich | Pharmacist | 515 Carlyle Avenue, Belleville, IL 62221 | 2017-08-16 |
| 1912422247 | Cherie Ann Klosterman | Psychologist | Belleville Area Special Services Cooperative, 2411 Pathways Crossing, Belleville, IL 62221 | 2017-08-08 |
| 1134391329 | Barbara Beckley | Home Health Aide | 2726 Cascade Lake Drive, Shiloh, IL 62221 | 2008-03-27 |
| 1356561666 | Belleville Area Spc Srv Co - Adm | Local Education Agency (LEA) | 2411 Pathways Crossing, Belleville, IL 62221 | 2007-04-27 |
| Find all providers in zip 62221 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "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. 62 |
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| 1447872676 | Vistalink Health Group, LLC | Point of Service | 2549 Waukegan Rd Ste 531, Bannockburn, IL 60015-1569 | 2020-05-11 |
| 1700419223 | Mckenna Counseling LLC | Point of Service | 3526 N California Ave Ste 101, Peoria, IL 61603-1143 | 2020-02-13 |
| 1790257723 | Epic Commiunity Development Center, Incorported | Point of Service | 18300 Dixie Hwy Fl 2, Homewood, IL 60430-3235 | 2019-01-02 |
| 1184192643 | Luann Bauer | Point of Service | 63 N Williams St, Crystal Lake, IL 60014-4443 | 2018-11-02 |
| 1033590427 | Interstate Phlebotomy Services Inc | Point of Service | 3200 Drover Ln, Darien, IL 60561-1642 | 2015-06-11 |
| 1699182642 | In Home Counseling for Seniors | Point of Service | 2318 N Lowell Ave, Chicago, IL 60639-3520 | 2014-07-22 |
| 1972934610 | Center for Vitality and Balance, LLC | Point of Service | 1280 Iroquois Ave Ste 404, Naperville, IL 60563-8570 | 2013-12-05 |
| 1720419732 | The Excellence Group, LLC | Point of Service | 1102 E 46th St Unit 202, Chicago, IL 60653-4435 | 2013-12-02 |
| 1457781916 | Applied Behavior Interventions | Point of Service | 219 N Oak Park Ave, Oak Park, IL 60302-2151 | 2013-11-20 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62221 |
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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.