Manor Care of Kankakee Il LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0027490 Issued in IL

Legal business name

MANOR CARE OF KANKAKEE IL LLC

Doing business as

ManorCare Health Services-Kankakee

Practice address

900 W River PL
Kankakee, IL 60901-2932

Phone

(815) 933-1711

Fax

(815) 933-2065

NPI assigned

Jun 1, 2006

Last updated

Apr 13, 2010By 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. Barry A Lazarus

Title

Vice President - Reimbursements

Phone

(419) 252-5541

Specialties & licenses 2

Addresses

Other names 1

• ManorCare Health Services-Kankakee Doing business as

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1063459626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "ATTN: BARRY LAZARUS",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-252-5541",
            "fax_number": "419-252-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W RIVER PL",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012932",
            "telephone_number": "815-933-1711",
            "fax_number": "815-933-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF KANKAKEE IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT - REIMBURSEMENTS",
        "authorized_official_telephone_number": "419-252-5541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0027490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ManorCare Health Services-Kankakee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maggie Ullrich LLC
• Josephine Majka
• Bonita L Malinowski, MS RD CSR LDN
• Jasmine Mathew Maly, M.D.
• Thaddeus Manczko, M.D.
• Vicky Lynn Mansberger, R.D.
• Thomas Paul Marcotte, RPH
• Andrew Tariao Mariano, DO
• Sara Joy Marion, PTA
• Gwen M Markham, CRNA

• Skilled Nursing Facility in Kankakee, IL
• Providers in Kankakee, 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 Apr 13, 2010; 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.