Presence Life Connections

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PRESENCE LIFE CONNECTIONS

Practice address

3330 Maria Linden Dr
Rockford, IL 61114-5480

Phone

(815) 877-7416

Fax

(815) 877-4299

NPI assigned

Sep 14, 2005

Organization subpart

Yes

Parent organization

PRESENCE LIFE CONNECTIONSAs reported in NPPES

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

Authorized official

Name

Michael Gordon

Title

Cfo

Phone

(708) 478-7911

Specialties & licenses 1

Addresses

Other names 1

• Presence Cor Mariae Center Doing business as

Part of

Presence Heritage Day Break

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124013255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18927 HICKORY CREEK DR STE 300",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488652",
            "telephone_number": "708-478-7900",
            "fax_number": "708-478-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MARIA LINDEN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145480",
            "telephone_number": "815-877-7416",
            "fax_number": "815-877-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE LIFE CONNECTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESENCE LIFE CONNECTIONS",
        "enumeration_date": "2005-09-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "708-478-7911"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence Cor Mariae Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Chiropractic Rockford
• Premise Health of Illinois Medical PC
• Emily Kay Prengel, PTA
• Jessica Prenot, NP
• Presence Life Connections
• Loretta Price
• Tori Leigh Price
• Debra Prichard-Hurt, LCSW
• Primary Eye Care Centers, PC
• Lauren Prince, DO

• Skilled Nursing Facility in Rockford, IL
• Providers in Rockford, 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 Jul 21, 2022; 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.