Paradox Champaign Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARADOX CHAMPAIGN OPERATOR LLC

Doing business as

Champaign Living Center

Practice address

309 E Springfield Ave
Champaign, IL 61820-5405

Phone

(217) 352-5135

NPI assigned

Jan 11, 2019

Organization subpart

No

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

Authorized official

Name

William Rothner

Title

Manager LLC

Phone

(847) 905-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Champaign Living Center Doing business as

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1144794207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E SPRINGFIELD AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205405",
            "telephone_number": "217-352-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E SPRINGFIELD AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205405",
            "telephone_number": "217-352-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADOX CHAMPAIGN OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "ROTHNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGER LLC",
        "authorized_official_telephone_number": "847-905-4000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT OF PUBLIC HEALTH",
            "identifier": "0055467",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champaign Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercedes Panepinto
• Paige Paulas Pantoja, OD
• Mbuyi Christian Panumpabi
• Karla M. Paquin, MHP
• Susan Elizabeth Paradee
• John Joohun Park, APRN
• Jong T Park, PT, MPT
• Peter Park, RPH
• Summer L Park, APN
• Caleb Steven Parker, HIGH SCHOOL DIPLOMA

• Skilled Nursing Facility in Champaign, IL
• Providers in Champaign, 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 Jan 11, 2019; 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.