NPIMap

Organization Active NPI

North Aurora Hco, LLC

Doing business as North Aurora Care Center

  • Nursing Facility/Intermediate Care Facility
  • North Aurora, IL
National Provider Identifier
1265479067
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0047514 Issued in IL
Legal business name
NORTH AURORA HCO, LLC
Doing business as
North Aurora Care Center
Practice address
310 Banbury Rd
North Aurora, IL 60542-1260
Phone
(630) 892-7627
Fax
(630) 892-7925
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Mark B. Petersen
Title
Manager
Phone
(309) 689-5880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0047514 IL Primary

Addresses

Primary practice location

310 Banbury Rd
North Aurora, IL 60542-1260

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113

Other identifiers 1

IdentifierTypeStateIssuer
203224201013MedicaidIL

Other names 1

  • North Aurora Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Aurora Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1265479067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BANBURY RD",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421260",
            "telephone_number": "630-892-7627",
            "fax_number": "630-892-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH AURORA HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-689-5880"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0047514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203224201013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Aurora Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Aurora Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.