Woodbine Nursing Home LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044446 Issued in IL

Legal business name

WOODBINE NURSING HOME LLC

Doing business as

The Woodbine

Practice address

6909 North Ave
Oak Park, IL 60302-1008

Phone

(708) 386-1112

Fax

(708) 524-4818

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Barak Baver

Title

Cfo

Phone

(773) 202-0000

Specialties & licenses 1

Addresses

Other names 1

• THE WOODBINE Doing business as

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093704165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 W PETERSON AVE",
            "address_2": "SUITE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466182",
            "telephone_number": "773-202-0000",
            "fax_number": "773-267-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021008",
            "telephone_number": "708-386-1112",
            "fax_number": "708-524-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBINE NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAVER",
        "authorized_official_first_name": "BARAK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-202-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE WOODBINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ka Ngan Wong, OTR/L
• Michelle Gloria Wong
• Sabina Nicole Wong, MD
• Wood Counseling Center, PLLC
• Amy Flanagan Wood, LMFT
• Martrice Woodfork
• Danielle Woods
• Sarita L Woodson, DDS
• Alyson Woody, MA, LCPC
• David Woznica, M.D.

• Skilled Nursing Facility in Oak Park, IL
• Providers in Oak Park, 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.