Pontiac Healthcare and Rehab,LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

53264 Issued in IL

Legal business name

PONTIAC HEALTHCARE AND REHAB,LLC

Practice address

300 W Lowell Ave
Pontiac, IL 61764-2614

Phone

(815) 842-1181

Fax

(815) 842-3406

NPI assigned

Oct 28, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Bradley M. Alter

Title

Managing Member

Phone

(847) 674-4700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1083019442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W LOWELL AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642614",
            "telephone_number": "815-842-1181",
            "fax_number": "815-842-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W LOWELL AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642614",
            "telephone_number": "815-842-1181",
            "fax_number": "815-842-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTIAC HEALTHCARE AND REHAB,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "ALTER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "847-674-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "53264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Renee Pina, CDS
• Laura Elizabeth Pittenger
• Vanessa L Pitts, M.D.
• Pontiac CC School Dist 429
• Pontiac Family Eye Care LLC
• Pontiac Supportive Living, LLC
• Pontiac TWP HS Dist 90
• Karissa Ann Poppen, PT
• Positive Direction Counseling, PC
• Premier Medical Group, LLC

• Skilled Nursing Facility in Pontiac, IL
• Providers in Pontiac, 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 Nov 17, 2016; 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.