Waterfront Terrace, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0028076 Issued in IL

Legal business name

WATERFRONT TERRACE, INC.

Practice address

7750 S South Shore Dr
Chicago, IL 60649-4434

Phone

(773) 731-4200

NPI assigned

Dec 26, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Marshall A Mauer

Title

Secretary-Treasurer

Phone

(847) 679-8219

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1285611830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762432",
            "telephone_number": "847-679-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 S SOUTH SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606494434",
            "telephone_number": "773-731-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFRONT TERRACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-26",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY-TREASURER",
        "authorized_official_telephone_number": "847-679-8219",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0028076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, 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 Nov 28, 2011; 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.