NPIMap

Organization Active NPI

Glenlake Terrace Nursing & Rehabilitation Ceter, LLC

  • Skilled Nursing Facility
  • Waukegan, IL
National Provider Identifier
1245337476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GLENLAKE TERRACE NURSING & REHABILITATION CETER, LLC
Practice address
2222 14TH St
Waukegan, IL 60085-7708
Phone
(847) 249-2400
Fax
(847) 249-0536
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Frances Meehan
Title
Attorney
Phone
(312) 207-6468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2222 14TH St
Waukegan, IL 60085-7708

Mailing address

2222 14TH St
Waukegan, IL 60085-7708
Phone (847) 249-2400

Other names 1

  • GlenLake Terrace 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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245337476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 14TH ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600857708",
            "telephone_number": "847-249-2400",
            "fax_number": "847-249-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 14TH ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600857708",
            "telephone_number": "847-249-2400",
            "fax_number": "847-249-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENLAKE TERRACE NURSING & REHABILITATION CETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEEHAN",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "ATTORNEY",
        "authorized_official_telephone_number": "312-207-6468",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GlenLake Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.