Pinnacle Healthcare of Waukegan

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044453 Issued in IL

Legal business name

PINNACLE HEALTHCARE OF WAUKEGAN

Practice address

2222 W 14TH Street
Waukegan, IL 60085

Phone

(847) 249-2400

Fax

(847) 249-0536

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By 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

Mrs. Edna B Brosas

Title

Manager

Phone

(847) 249-2400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033290986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N MILWAUKEE AVE",
            "address_2": "SUITE 140",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "847-541-9100",
            "fax_number": "847-541-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W 14TH STREET",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-249-2400",
            "fax_number": "847-249-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTHCARE OF WAUKEGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROSAS",
        "authorized_official_first_name": "EDNA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-249-2400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell Bryan Pierson
• Lenette Ann Pietscher
• Mary J Pihlaja, RN
• Matthew David Pikus
• Roxanne Pilger, M.S. CCC-SLP
• Amanda Rene Pitcock, BA
• Joseph M Plaminek
• Planned Parenthood of Illinois
• Brianna Marie Ploessl
• Podomedik LLC (Carmen Sebastian-Novell)

• Skilled Nursing Facility in Waukegan, IL
• Providers in Waukegan, 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 Aug 22, 2020; 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.