Woodstock Christian Life Services

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

6009310 Issued in IL

Legal business name

WOODSTOCK CHRISTIAN LIFE SERVICES

Doing business as

Hearthstone Manor

Practice address

920 N Seminary Ave
Woodstock, IL 60098-2996

Phone

(815) 334-6200

Fax

(815) 338-8846

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Matthew Boswell

Title

Vice President of Finance

Phone

(716) 338-9766

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Hearthstone Manor Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1225256696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 CHRISTIAN WAY",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982912",
            "telephone_number": "815-334-6200",
            "fax_number": "815-206-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 N SEMINARY AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982996",
            "telephone_number": "815-334-6200",
            "fax_number": "815-338-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK CHRISTIAN LIFE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "BOSWELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "716-338-9766"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "6009310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NUMBER",
            "identifier": "6009310",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL PROVIDER NUMBER",
            "identifier": "14A349",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hearthstone Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hearthstone Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krystyna Janina Wojtowicz, MA, LCPC
• Robert Wolf
• Maria Wondra, D.P.T.
• James L Woodman, MD
• Woodstock Chiropractic Center
• Woodstock Dental Associates, LTD.
• Woodstock Fire/Rescue District
• Woodstock Imaging Associates, Inc.
• Woodstock Medical & Surgical Center, LTD
• Woodstock Nursing and Rehab Center LLC (La Bella of Woodstock)

• Skilled Nursing Facility in Woodstock, IL
• Providers in Woodstock, 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 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.