NPIMap

Organization Active NPI

Thi of Illinois at Brentwood, LLC

Doing business as Brentwood Sub-Acute Healthcare Center

  • Skilled Nursing Facility
  • Burbank, IL
National Provider Identifier
1124048509
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0046466 Issued in IL
Legal business name
THI OF ILLINOIS AT BRENTWOOD, LLC
Doing business as
Brentwood Sub-Acute Healthcare Center
Practice address
5400 W 87TH St
Burbank, IL 60459-2913
Phone
(708) 423-1200
NPI assigned
Jul 20, 2006
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Kristin Mitchell
Title
President
Phone
(708) 423-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046466 IL Primary

Addresses

Primary practice location

5400 W 87TH St
Burbank, IL 60459-2913

Mailing address

930 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other names 1

  • Brentwood Sub-Acute Healthcare Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1124048509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000",
            "fax_number": "410-773-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 W 87TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592913",
            "telephone_number": "708-423-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF ILLINOIS AT BRENTWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-423-1200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Sub-Acute Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.