NPIMap

Organization Active NPI

Residential Alternatives of Illinois, Inc

Doing business as Coralville Manor LLC , Windmill Manor

  • Skilled Nursing Facility
  • Coralville, IA
National Provider Identifier
1295723500
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
165545 Issued in IA
Legal business name
RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC
Doing business as
Coralville Manor LLC , Windmill Manor
Practice address
2332 Liberty Dr
Coralville, IA 52241-2771
Phone
(319) 545-7390
Fax
(319) 545-7393
NPI assigned
Oct 11, 2005
Last updated
Jul 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Authorized official

Name
Mr. Ronald J Wilson
Title
Chief Financial Officer
Phone
(309) 343-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 165545 IA Primary

Addresses

Primary practice location

2332 Liberty Dr
Coralville, IA 52241-2771

Mailing address

2332 Liberty Dr
Coralville, IA 52241-2771
Phone (319) 545-7390

Other identifiers 2

IdentifierTypeStateIssuer
65545OtherIABLUE CROSS BLUE SHEILD #
0809673MedicaidIA

Other names 1

  • Coralville Manor LLC , Windmill Manor Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150115000514 IA Part A Provider - Skilled Nursing Facility 0941197354 Practice locations: Coralville, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295723500. Details of each certification follow.

Skilled nursing facility certification: CCN 165545

Legal name
RESIDENTIAL ALTERNATIVES OF ILLINOIS INC
Doing business as
WINDMILL MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 29, 2004
Last certification
Apr 17, 2025
Beds
120
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Residential Alternatives of Illinois
Organization structure
CorporationNon-profit
Incorporated
Nov 13, 1987 in IL
Enrollment address
2332 Liberty Dr
Coralville, IA 52241-2771
Nursing home name
WINDMILL MANOR
Affiliated entity
RESIDENTIAL ALTERNATIVES OF ILLINOIS

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Windmill ManorCCN 165545 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 29, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120108.9 residents per day on average
Chain
Residential Alternatives of Illinois7 facilities in the chain
Penalties (3 years)
1Fines totaling $11,213

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1022298Windmill Manor2332 Liberty Drive, Coralville, IA 52241Certificate of waiverFeb 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Residential Alternatives of Illinois Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Residential Alternatives of Illinois Inc Organization, Galesburg, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 6, 2022 100%
Stacey L Cremeens Individual W-2 Managing EmployeeAdministrator Apr 1, 2014
Ronald J Wilson Individual Corporate OfficerChief Financial Officer Apr 1, 2014
OtherChief Financial Officer Apr 1, 2014
William L Kempiners Individual Corporate DirectorBoard Member Aug 1, 2014
Benjamin L McMahan Individual Corporate DirectorDirector Mar 31, 2022
Jeffrey W. Shaw Individual Corporate OfficerSecretary of Board of Directors Aug 1, 2014
Corporate DirectorBoard Member Aug 1, 2014
John P Kniery Individual Corporate OfficerPresident Apr 1, 2014
Corporate Director Apr 1, 2014

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Manor Court of PrincetonPrinceton, IL, CCN 146083 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 3, 2005
Manor Court of PeruPeru, IL, CCN 146091 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 10, 2022
Manor Court of FreeportFreeport, IL, CCN 146102 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 9, 2006
Hawthorne Inn of DanvilleDanville, IL, CCN 146090 Skilled nursing facility Operational/Managerial Control (100%) Mar 10, 2022
Manor Court of RochelleRochelle, IL, CCN 146193 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 17, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1295723500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 LIBERTY DR",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412771",
            "telephone_number": "319-545-7390",
            "fax_number": "319-545-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 LIBERTY DR",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412771",
            "telephone_number": "319-545-7390",
            "fax_number": "319-545-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "165545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD #",
            "identifier": "65545",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809673",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coralville Manor LLC , Windmill Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.