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Organization Active NPI

Victory Centre of Vernon Hills LLC

  • Assisted Living Facility
  • Vernon Hills, IL
National Provider Identifier
1033476510
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
VICTORY CENTRE OF VERNON HILLS LLC
Practice address
97 W Phillip Rd
Vernon Hills, IL 60061-1723
Phone
(847) 549-6070
Fax
(847) 367-5530
NPI assigned
Apr 20, 2012
Organization subpart
Yes
Parent organization
PSL HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Kristen Becht
Title
Risk Manager
Phone
(312) 837-0710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X IL Primary

Addresses

Primary practice location

97 W Phillip Rd
Vernon Hills, IL 60061-1723

Mailing address

30 S Wacker Dr Ste 1010
Chicago, IL 60606-7413
Phone (312) 837-0701

Other identifiers 1

IdentifierTypeStateIssuer
364363583001MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1033476510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S WACKER DR STE 1010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606067413",
            "telephone_number": "312-837-0701",
            "fax_number": "312-837-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 W PHILLIP RD",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611723",
            "telephone_number": "847-549-6070",
            "fax_number": "847-367-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY CENTRE OF VERNON HILLS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSL HOLDINGS LLC",
        "enumeration_date": "2012-04-20",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "BECHT",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "RISK MANAGER",
        "authorized_official_telephone_number": "312-837-0710"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364363583001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.