ILLINOIS VETERANS HOME AT LASALLE (NPI# 1942367453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942367453 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VETERANS HOME AT LASALLE |
| Practice Address |
1015 Oconor Ave La Salle IL 61301-1216 |
| Practice Telephone | 8152230303 |
| Practice Fax Number | 8152235815 |
| Mailing Telephone | 2172229487 |
| Mailing Fax Number | 2172228578 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2013-05-24 |
| Authorized Official Name | JOHN G. KOEHLER (ADMINISTRATOR) |
| Authorized Official Telephone | 8152230303 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
44115 | IL | Nursing & Custodial Care Facilities |
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 44115 | IL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 05032039 | 01 |
| Street Address |
1015 OCONOR AVE |
| City | LA SALLE |
| State | IL |
| Zip Code | 61301-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750448627 | Alan J Blomquist | Social Worker | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2007-01-02 |
| 1417555020 | Peter O'keefe | Occupational Therapist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2020-10-15 |
| 1710531470 | Mackenzie Elise Benning | Occupational Therapist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2019-07-30 |
| 1972169985 | Jennifer Lynn Burwell | Occupational Therapist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2019-05-15 |
| 1750870382 | Bree N Carlson | Speech-Language Pathologist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2018-05-09 |
| 1609226596 | Shannon Jenkins-solomon | Physical Therapy Assistant | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2016-06-21 |
| 1104287226 | Katherine Ann Schickedanz | Occupational Therapist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2016-03-17 |
| 1003207051 | Ashwin Yegneswar | Home Health | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2015-02-12 |
| 1932444270 | Kristin Ann Wackerlin | Speech-Language Pathologist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2012-11-27 |
| 1184926511 | Karen R. Dunne | Speech-Language Pathologist | 1015 Oconor Ave, La Salle, IL 61301-1216 | 2010-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598912453 | Matthew V Hartman | Dentist | 941 First St, La Salle, IL 61301 | 2008-08-22 |
| 1164501078 | Pamela F Wolf | Counselor | 146 Gooding Street, La Salle, IL 61301 | 2006-11-02 |
| 1265514343 | Rose Mary Schaumberg | Nurse Practitioner | 2970 Chartres Street, Lasalle, IL 61301 | 2006-10-19 |
| 1578668141 | Cynthia L. Ashley | Psychologist | 206 Marquette Street, Suite 203, Lasalle, IL 61301 | 2006-09-14 |
| 1922016849 | Mary Therese Petrella | Nurse Practitioner | 2970 Chartres, Hygienic Institute Community Health Clinic, La Salle, IL 61301 | 2006-08-04 |
| 1073527461 | William L Judge | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2006-07-28 |
| 1124044318 | North Central Behavioral Health Systems, Inc | Clinic/Center | 2960 Chartres St., Lasalle, IL 61301 | 2006-07-14 |
| 1962445247 | William Michael White | Dentist | 225 Gooding St, Suite 1, La Salle, IL 61301 | 2006-06-14 |
| 1730629429 | Liberty Kathleen Grzybowski | Social Worker | 2960 Chartres St., La Salle, IL 61301 | 2017-03-01 |
| 1619267135 | Gergovich Family Chiropractic, LLC. | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2011-04-18 |
| Find all providers in zip 61301 | ||||
| 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 |
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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.