HERITAGE MANOR - MINONK, LLC (NPI# 1558605261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558605261 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR - MINONK, LLC |
| Other Organization Name | HERITAGE HEALTH |
| Practice Address |
201 Locust St Minonk IL 61760-1511 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 3094322557 |
| Practice Fax Number | 3094322674 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2016-09-13 |
| Authorized Official Name | DAVID M UNDERWOOD (EXEC VP, CFO) |
| Authorized Official Telephone | 3098237135 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ENTERPRISES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers |
| Other Name | Type Code |
|---|---|
| Heritage Health | Doing Business As Name - Organization |
| Street Address |
201 LOCUST ST |
| City | MINONK |
| State | IL |
| Zip Code | 61760-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750372801 | Heritage Manor Minonk, LLC | Occupational Therapist | 201 Locust St, Minonk, IL 61760-1511 | 2005-10-28 |
| 1164775565 | Amy Rice | Physical Therapy Assistant | 201 Locust St, Minonk, IL 61760-1511 | 2012-10-23 |
| 1497076103 | Russa Aussieker | Physical Therapy Assistant | 201 Locust St, Minonk, IL 61760-1511 | 2010-06-16 |
| 1700107406 | Madena Whitesell | Occupational Therapy Assistant | 201 Locust St, Minonk, IL 61760-1511 | 2010-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245221068 | Green Tree Pharmacy, Inc. | Pharmacy | 1305 Carolyn Dr, Minonk, IL 61760 | 2005-11-01 |
| 1477899805 | Timothy Gordon Weech | Chiropractor | 140 W 6th St, Minonk, IL 61760 | 2012-12-12 |
| 1528573029 | Amy Naas | Speech-Language Pathologist | 404 W 8th St, Minonk, IL 61760-1017 | 2017-12-06 |
| 1902048986 | Jessica Lynn White | Internal Medicine | 120 E 7th St, Minonk, IL 61760-1135 | 2009-04-06 |
| 1295852515 | City of Minonk of Woodford County | Ambulance | 636 Jefferson St, Minonk, IL 61760-1243 | 2007-03-23 |
| 1033240767 | Neil Paul Heineke | Pharmacist | 568 N Chestnut St, Minonk, IL 61760-1271 | 2007-03-07 |
| 1487958914 | David D Wegman | Pharmacist | 568 N Chestnut St, Minonk, IL 61760-1271 | 2010-12-23 |
| 1780669309 | Sharon A Austin | Nurse Practitioner | 200 E 6th St, Minonk, IL 61760-1308 | 2005-12-07 |
| 1225013840 | John E Podzamsky | Family Medicine | 200 E 6th St, Minonk, IL 61760-1308 | 2005-12-07 |
| 1164772778 | Eric Ross Saxton | Physical Therapist | 541 Oak St, Minonk, IL 61760-1310 | 2012-09-12 |
| Find all providers in zip 61760 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699026 | First Choice Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 65 S 65th St Ste 10, Belleville, IL 62223-2946 | 2020-11-04 |
| 1619596624 | Gz Service Inc | Durable Medical Equipment & Medical Supplies | 576 Jennifer Cir, Mundelein, IL 60060-4110 | 2020-04-09 |
| 1528690526 | Nationwide Medical, Inc. | Durable Medical Equipment & Medical Supplies | 415 W Golf Rd Ste 48, Arlington Heights, IL 60005-3923 | 2020-02-07 |
| 1477024347 | Karma7 Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1840 Industrial Dr Ste 160, Libertyville, IL 60048-9400 | 2018-12-17 |
| 1700354354 | True Respiratory Care & Medical Management LLC | Durable Medical Equipment & Medical Supplies | 11415 183rd Pl Ste B, Orland Park, IL 60467-5011 | 2018-11-12 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1487103560 | The Elms | Durable Medical Equipment & Medical Supplies | 1212 Madelyn Ave, Macomb, IL 61455-3324 | 2016-09-29 |
| 1457807257 | Genventures Inc | Durable Medical Equipment & Medical Supplies | 101 S. College Avenue, Aledo, IL 61231-1630 | 2016-08-31 |
| Find all providers with the same taxonomy | ||||
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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.