Elm City Rehabilitation Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ELM CITY REHABILITATION CENTER, INC.

Practice address

310 N Main St
Jacksonville, IL 62650-2021

Phone

(217) 245-9504

Fax

(217) 243-2350

NPI assigned

Feb 25, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Frederick

Title

President/Ceo

Phone

(217) 245-9504

Specialties & licenses 2

Addresses

Other names 1

• Elm City Center Doing business as

Tax ID family

Elm City Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Elm City Rehabilitation Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, IL
  • NPI 1104061662
  NPD tax ID
• Elm City Rehabilitation Center, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, IL
  • NPI 1679924450
  NPD tax ID
• Elm City Rehabilitation Center, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, IL
  • NPI 1902934102
  NPD tax ID

Locations

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1023258456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501148",
            "telephone_number": "217-245-9504",
            "fax_number": "217-243-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N MAIN ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502021",
            "telephone_number": "217-245-9504",
            "fax_number": "217-243-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM CITY REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "217-245-9504",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm City Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ward Richard Dunseth II, CRNA
• Dva Renal Healthcare Inc
• Kathy Moore Dyson, LCPC
• Babu Rao Eladasari, MD,FACP
• Eldon G Barrowes DDS & Assoc PC
• Elm City Rehabilitation Center, Inc.
• Elm City Rehabilitation Center, Inc.
• Elm City Rehabilitation Center, Inc.
• Empowerme Rehabilitation Il Agency, LLC
• Valerie Ernst, PT

• Community/Behavioral Health Agency in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.