Pinnacle Healthcare of Berwyn

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0046292 Issued in IL

Legal business name

PINNACLE HEALTHCARE OF BERWYN

Practice address

3601 S Harlem
Berwyn, IL 60422

Phone

(708) 749-4160

Fax

(708) 749-7696

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Edna B Brosas

Title

Manager

Phone

(847) 541-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306927256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N MILWAUKEE AVE",
            "address_2": "SUITE 140",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "847-541-9100",
            "fax_number": "847-541-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S HARLEM",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60422",
            "telephone_number": "708-749-4160",
            "fax_number": "708-749-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTHCARE OF BERWYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROSAS",
        "authorized_official_first_name": "EDNA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-541-9100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.