ILLINOIS VETERANS HOME AT MANTENO (NPI# 1831248228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831248228 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VETERANS HOME AT MANTENO |
| Practice Address |
1 Veterans Dr Manteno IL 60950-9466 |
| Mailing Address |
1 Veterans Dr Bldg A-2m Manteno IL 60950-9466 |
| Practice Telephone | 8154686581 |
| Practice Fax Number | 8154687001 |
| Mailing Telephone | 2172229487 |
| Mailing Fax Number | 2172228578 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2010-07-15 |
| Authorized Official Name | REGINALD L BOOKER (ADMINISTRATOR) |
| Authorized Official Telephone | 8154686581 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
0042218 | IL | Nursing & Custodial Care Facilities |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 0042218 | IL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 04621430 | 01 |
| Street Address |
1 VETERANS DR |
| City | MANTENO |
| State | IL |
| Zip Code | 60950-9466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505033 | Margaret O'brien | Speech-Language Pathologist | 1 Veterans Dr, Manteno, IL 60950-9466 | 2020-10-12 |
| 1942865423 | Kevin Majchrzak | Occupational Therapist | 1 Veterans Dr, Manteno, IL 60950-9466 | 2019-05-09 |
| 1457915506 | Alyssa S Moravec | Occupational Therapist | 1 Veterans Dr, Manteno, IL 60950-9466 | 2019-04-24 |
| 1487951018 | Elaine Buchanan | Marriage & Family Therapist | 1 Veterans Dr, Manteno, IL 60950-9466 | 2011-02-17 |
| 1194814814 | Christina Deckelman | Nurse Practitioner | 1 Veterans Dr, Manteno, IL 60950-9466 | 2006-10-12 |
| 1447344205 | Madhu Malhotra | Internal Medicine | 1 Veterans Dr, Manteno, IL 60950-9466 | 2006-10-03 |
| 1922058726 | Beth Rogers | Nurse Practitioner | 1 Veterans Dr, Manteno, IL 60950-9466 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710344338 | Specialized Assistance Services, Nfp | Clinic/Center | 333 W Evergreen St, Manteno, IL 60950 | 2016-01-27 |
| 1588004667 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 175 Evergreen, Manteno, IL 60950 | 2013-07-03 |
| 1649610841 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 325 Hemlock, Manteno, IL 60950 | 2013-07-02 |
| 1811337280 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 215 Hemlock, Manteno, IL 60950 | 2013-07-01 |
| 1407296981 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 365 Hemlock, Manteno, IL 60950 | 2013-06-28 |
| 1760822142 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 185 Chestnut, Manteno, IL 60950 | 2013-06-28 |
| 1598105975 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 280 Ironwood, Manteno, IL 60950 | 2013-06-28 |
| 1942640339 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 360 Ironwood, Manteno, IL 60950 | 2013-06-28 |
| 1215377692 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 110 Evergreen, Manteno, IL 60950 | 2013-06-28 |
| 1972862787 | Karl A Keller | Dentist | 312 W. Division, Manteno, IL 60950 | 2012-05-14 |
| Find all providers in zip 60950 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356890453 | Dhs | Residential Treatment Facility, Physical Disabilities | 109 W Wilson St, Fairfield, IL 62837-1816 | 2016-09-30 |
| 1790150340 | Mary Kay Yarak | Residential Treatment Facility, Physical Disabilities | 1537 N Washtenaw Ave, Chicago, IL 60622-1636 | 2015-12-08 |
| 1629448592 | Lilia Perez | Residential Treatment Facility, Physical Disabilities | 225 Westview St, Hoffman Estates, IL 60169-3055 | 2015-10-04 |
| 1912394354 | Rehab Care | Residential Treatment Facility, Physical Disabilities | 5112 Johnson Ave, Western Springs, IL 60558-1913 | 2015-04-23 |
| 1871897694 | Unicare Home Health Inc. | Residential Treatment Facility, Physical Disabilities | 3862 Rita Dr, Richton Park, IL 60471-1283 | 2011-01-09 |
| 1598942252 | Home Bound Eye Care Services Ltd | Residential Treatment Facility, Physical Disabilities | 5301 Touhy Ave, Suite 100, Skokie, IL 60077-3247 | 2008-01-24 |
| 1922185958 | Dav-kim Portable X Ray Service Co | Residential Treatment Facility, Physical Disabilities | 8235 Christiana Ave, Skokie, IL 60076-2910 | 2006-11-01 |
| 1609890235 | State of Illinois | Residential Treatment Facility, Physical Disabilities | 2424w.charleston, Chicago, IL 60647 | 2006-07-27 |
| 1619359866 | Ton Shen Health, Inc. | Residential Treatment Facility, Physical Disabilities | 665 Pasquinelli Dr, Suite 203, Westmont, IL 60559-1279 | 2015-06-24 |
| 1285013235 | Quality Therapy and Consultation | Residential Treatment Facility, Physical Disabilities | 28w141 Liberty St, Winfield, IL 60190-1955 | 2015-05-22 |
| 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.