McKinley Court LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

42499 Issued in IL

Legal business name

MCKINLEY COURT LLC

Practice address

500 W McKinley Ave
Decatur, IL 62526-3281

Phone

(217) 875-0020

Fax

(217) 875-0647

NPI assigned

Dec 20, 2005

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Charles Braun

Title

Controller

Phone

(847) 583-0100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1033195276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263281",
            "telephone_number": "217-875-0020",
            "fax_number": "217-875-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263281",
            "telephone_number": "217-875-0020",
            "fax_number": "217-875-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKINLEY COURT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "847-583-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "42499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH LICENSE NUMBER",
            "identifier": "42499",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH FACILITY NUMBER",
            "identifier": "6005938",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darris McFall
• Stephanie Kay McGinley, COTA/L
• Bonnie Marie McGlothlin
• Patricia S McGuire, PH.D.
• Sarah Thompson McHugh, M.D.
• Malaysia McKinney
• Jayonna McKinstry, RBT
• Amy McLain, APN
• Elissa Marie McLane, OTR/L
• Lesa J McMahon-Lowe, LCPC

• Skilled Nursing Facility in Decatur, IL
• Providers in Decatur, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.