CC CARE LLC (NPI# 1629340690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629340690 |
| Entity Type | Organization |
| Organization Name | CC CARE LLC |
| Other Organization Name | COMMUNITY CARE CENTER |
| Practice Address |
4314 S Wabash Ave Chicago IL 60653-3119 |
| Practice Telephone | 7735388300 |
| Practice Fax Number | 7735385775 |
| Mailing Telephone | 7735388300 |
| Mailing Fax Number | 7735385775 |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2016-08-24 |
| Authorized Official Name | MR. JAMIE NICKLE (DIRECTOR) |
| Authorized Official Telephone | 6305010996 |
| Is Organization Subpart | Y |
| Parent Organization Name | JLM FINANCIAL HEALTHCARE, LP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0051722 | 05 |
| Other Name | Type Code |
|---|---|
| Community Care Center | Doing Business As Name - Organization |
| Street Address |
4314 S WABASH AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60653-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083664304 | Community Care Center | Skilled Nursing Facility | 4314 S Wabash Ave, Chicago, IL 60653-3119 | 2006-05-10 |
| 1205488947 | Laureate Chicago Operations LLC | Skilled Nursing Facility | 4314 S Wabash Ave, Chicago, IL 60653-3119 | 2019-07-12 |
| 1730426743 | Monique Harden | Occupational Therapist | 4314 S Wabash Ave, Chicago, IL 60653-3119 | 2013-01-10 |
| 1649535972 | Bon Gamiao Pacis | Physical Therapist | 4314 S Wabash Ave, Chicago, IL 60653-3119 | 2012-07-12 |
| 1639259864 | Community Care Operator LLC | Skilled Nursing Facility | 4314 S Wabash Ave, Chicago, IL 60653-3119 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
| 1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
| 1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
| 1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
| 1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
| 1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
| 1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
| Find all providers in zip 60653 | ||||
| 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 |
|---|---|---|---|---|
| 1053812974 | Alden Estates-courts of Huntley, Inc. | Skilled Nursing Facility | 4200 W Peterson Ave Ste 140, Chicago, IL 60646-6819 | 2018-02-26 |
| 1194271825 | Veronica Mack | Skilled Nursing Facility | 9738 S Merrion Ave, Chicago, IL 60617-4846 | 2016-09-01 |
| 1982050886 | Bernadette Aguilar | Skilled Nursing Facility | 125 S Green St, Unit 808a, Chicago, IL 60607-3197 | 2016-05-10 |
| 1720445539 | Maria Callahan | Skilled Nursing Facility | 1839 S Prairie Pkwy, Chicago, IL 60616-4389 | 2016-01-25 |
| 1265856710 | Royal Staff Inc | Skilled Nursing Facility | 10934 S Beverly Ave, Chicago, IL 60643-3752 | 2014-02-04 |
| 1114355336 | Mobile Anesthesiologist | Skilled Nursing Facility | 8420 Bryn Mawr, Chicago, IL 60631 | 2013-10-25 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1982946604 | Admiral At The Lake | Skilled Nursing Facility | 933 W. Foster Ave, Chicago, IL 60640 | 2013-03-20 |
| 1730447566 | Sound Imaging Inc. | Skilled Nursing Facility | 6970 N Mcalpin Ave, Chicago, IL 60646-1141 | 2012-04-30 |
| 1821355561 | Ltc Practitioners of Illinois | Skilled Nursing Facility | 3915 N. Kenneth Ave., Chicago, IL 60641-2816 | 2012-04-19 |
| Find all providers in CHICAGO | ||||
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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.