Manor Care of Oak Lawn (East) Il, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0027557 Issued in IL

Legal business name

MANOR CARE OF OAK LAWN (EAST) IL, LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Oak Lawn East)

Practice address

9401 S Kostner Ave
Oak Lawn, IL 60453-2697

Phone

(708) 423-7882

Fax

(708) 423-7947

NPI assigned

Jun 1, 2006

Last updated

Feb 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Oak Lawn East) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1174560528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 S KOSTNER AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532697",
            "telephone_number": "708-423-7882",
            "fax_number": "708-423-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF OAK LAWN (EAST) IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0027557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Oak Lawn East)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meredith Ann Manire, MD, PHD
• Carolyn Wassberg Manley, LCPC
• Amr Mannaa
• Sarah Tierney Manning, PA-C
• Scherry Manning
• Manor Care of Oak Lawn (West) Il, LLC (ProMedica Skilled Nursing and Rehabilitation (Oak Lawn West))
• Madeline E. Manske, SLP
• Sheena Agarwal Mansukhani, D.O.
• Lifang Mao, MD
• Sonja Marcic, MD

• Skilled Nursing Facility in Oak Lawn, IL
• Providers in Oak Lawn, 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 Feb 28, 2023; 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.