Champaign Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CHAMPAIGN REHABILITATION CENTER LLC

Practice address

1915 S Mattis Ave
Champaign, IL 61821-5919

Phone

(217) 352-0516

Fax

(866) 840-9609

NPI assigned

Feb 9, 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

Mananger

Phone

(847) 261-2400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1174088538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021519",
            "telephone_number": "847-261-2420",
            "fax_number": "866-840-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 S MATTIS AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215919",
            "telephone_number": "217-352-0516",
            "fax_number": "866-840-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-09",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "ROTHNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANANGER",
        "authorized_official_telephone_number": "847-261-2400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 15, 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.