Park Lawn Home

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0035527 Issued in IL

Legal business name

PARK LAWN HOME

Practice address

10833 Laporte Ave
Oak Lawn, IL 60453-5412

Phone

(708) 425-3344

Fax

(708) 425-3530

NPI assigned

Sep 27, 2010

Organization subpart

Yes

Parent organization

PARK LAWN SCHOOL & ACTIVITY CENTER, INC.As reported in NPPES

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

Authorized official

Name

James R. Weise

Title

Executive Director

Phone

(708) 425-3344

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Park Lawn Center3 organizations share this tax ID, including this one

Part of

Park Lawn Center

Other organizations with this tax ID 2

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

• Park Lawn Center

  • Intellectual Disabilities Intermediate Care Facility
  • Oak Lawn, IL
  • NPI 1467761312
  NPD tax ID
• Park Lawn School & Activity Center, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oak Lawn, IL
  • NPI 1609094788
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Park Lawn School & Activity Center, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oak Lawn, IL
  • NPI 1609094788
  NPPES parent name

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1285943134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 S KOSTNER AVE",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608032625",
            "telephone_number": "708-385-1982",
            "fax_number": "708-385-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LAPORTE AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535412",
            "telephone_number": "708-425-3344",
            "fax_number": "708-425-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK LAWN HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK LAWN SCHOOL & ACTIVITY CENTER, INC.",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "WEISE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-425-3344"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0035527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035527",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manuel Alberto Paredes Flores, MD
• Eva Alicia Paredes, OTR/L
• Trupti R Parikh, CPNP-PC
• Nicole Paris, BCBA
• Park Lawn Center
• Park Lawn School & Activity Center, Inc.
• Michelle Park-Huang
• Jimmy K Park, MD
• Ashley Denise Parker-Shearer
• Judith M Parker, R.N.

• Intellectual Disabilities Intermediate Care Facility in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Intellectual Disabilities Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.