MONTCLARE SENIOR RESIDENCES SLF OF LAWNDALE LLC (NPI# 1922543917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922543917 |
| Entity Type | Organization |
| Organization Name | MONTCLARE SENIOR RESIDENCES SLF OF LAWNDALE LLC |
| Other Organization Name | MONTCLARE SENIOR RESIDENCES SLF OF LAWNDALE |
| Practice Address |
4339 West 18th Place Chicago IL 60623 |
| Practice Telephone | 7732770288 |
| Practice Fax Number | 7732770312 |
| Mailing Telephone | 7732770288 |
| Mailing Fax Number | 7732770312 |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |
| Authorized Official Name | JOELLEN BLEAVINS (PRESIDENT OF MANAGEMENT AGENT) |
| Authorized Official Telephone | 8159351992 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Montclare Senior Residences SLF of Lawndale | Doing Business As Name - Organization |
| Street Address |
4339 WEST 18TH PLACE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1679024376 | Athletico Ltd. | Physical Therapist | 2632 W. Pershing Rd., Chicago, IL 60623 | 2016-10-18 |
| 1245691211 | L A Jones Hair Restoration Center | Prosthetic/Orthotic Supplier | 1657 S. Troy, Chicago, IL 60623 | 2016-03-17 |
| 1982019204 | Sonrisa Dental Little Village 26th | Clinic/Center | 3059 S 26th St, Chicago, IL 60623 | 2014-06-25 |
| 1992055487 | Margaret C Johnson | Nurse Practitioner | 3860 W. Ogden Ave, Chicago, IL 60623 | 2012-09-12 |
| 1477851319 | Elizabeth Bauer | Physician Assistant | 3256 W 24th St, Chicago, IL 60623 | 2011-03-01 |
| 1023328390 | Rebecca Franco | Advanced Practice Midwife | 2875 W. 19th St, Chicago, IL 60623 | 2010-10-20 |
| 1447580899 | Candace Nicole Hutchen | Pharmacist | 3434 West 13th Place, Chicago, IL 60623 | 2010-01-07 |
| 1689801680 | Braceman P&o Inc. | Prosthetic/Orthotic Supplier | 2830 W. Cermak Rd., Chicago, IL 60623 | 2009-06-17 |
| 1861639023 | Community Occupational Therapy | Occupational Therapist | 3000 S. Pulaski Rd., Chgo, IL 60623 | 2009-01-09 |
| Find all providers in zip 60623 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275184889 | The Encore At The Twin Cities | Assisted Living Facility | 101 N Wacker Dr Ste 608, Chicago, IL 60606-1726 | 2019-09-25 |
| 1851849269 | Alden Courts of Waterford, L.L.C. | Assisted Living Facility | 4200 W. Peterson Ave. Suite 140, Chicago, IL 60646-6074 | 2016-09-14 |
| 1740635663 | Friend Family Health Center, Inc | Assisted Living Facility | 6134 S Cottage Grove Ave, Chicago, IL 60637 | 2016-04-28 |
| 1760851364 | Goldblatts of Chicago Limited Partnership | Assisted Living Facility | 4707 S Marshfield Ave, Chicago, IL 60609-4159 | 2015-09-24 |
| 1982900445 | Covenant Home of Chicago | Assisted Living Facility | 2720 West Foster Avenue, Chicago, IL 60625-3510 | 2011-02-01 |
| 1215269071 | Renaissance Saint Luke Slf Lp | Assisted Living Facility | 1501 W Melrose St, Chicago, IL 60657-9083 | 2010-02-04 |
| 1346579398 | Genesis Rehabilitation Services | Assisted Living Facility | 7120 N Sheridan Rd, # 201, Chicago, IL 60626-2900 | 2009-12-21 |
| 1992946214 | Victory Centre of South Chicago LLC | Assisted Living Facility | 3251 E 92nd St, Chicago, IL 60617-4660 | 2009-03-17 |
| 1861638181 | Victory Centre of Galewood LLC | Assisted Living Facility | 2370 N Newcastle Ave, Chicago, IL 60707-2955 | 2008-12-17 |
| 1487803938 | Cortland Manor LLC | Assisted Living Facility | 1900 N. Karlov Ave., Chicago, IL 60639 | 2008-09-09 |
| 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.