PMR Illinois Holding, LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

PMR ILLINOIS HOLDING, LLC

Doing business as

JenCare Senior Medical Center Dolton

Practice address

600 E Sibley Blvd
Dolton, IL 60419-2599

Phone

(708) 340-7400

NPI assigned

Aug 28, 2020

Last updated

Oct 31, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

PMR ILLINOIS HOLDING, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Chen

Title

Authorized Official

Phone

(305) 831-4722

Specialties & licenses 1

Addresses

Other names 1

• JenCare Senior Medical Center Dolton Doing business as

Tax ID family

PMR Illinois Holding LLC3 organizations share this tax ID, including this one

Part of

PMR Illinois Holding LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• PMR Georgia Holding, LLC

  dba Jencare Neighborhood Medical Center

  • Specialist
  • Miami Gardens, FL
  • NPI 1609329630
  NPD tax ID
• PMR Illinois Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1770038671
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1013520113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E SIBLEY BLVD",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192599",
            "telephone_number": "708-340-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR ILLINOIS HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PMR ILLINOIS HOLDING, LLC",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-831-4722"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JenCare Senior Medical Center Dolton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JenCare Senior Medical Center Dolton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arlene Perry
• Quinisha Perry
• Diana M. Pierce, SCHOOL PSYCHOLOGIST
• Pioneer Concepts Inc (Dolton Court)
• Pleasant Dental LLC
• Leonard Pollard
• Shytia Lincole Porter
• Power of Touch Massage Therpay
• Chantel Prater
• Quality Dental, Inc

• Non-Pharmacy Dispensing Site in Dolton, IL
• Providers in Dolton, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.