St. Charles Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5103970 Issued in IL

Legal business name

ST. CHARLES MEMORY CARE, LLC

Practice address

10 N Peck Rd
St Charles, IL 60175-1043

Phone

(630) 485-4510

Fax

(630) 485-4511

NPI assigned

Jul 1, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Chad Anderson

Title

President

Phone

(214) 845-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1356781645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E JOHN CARPENTER FWY",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623931",
            "telephone_number": "214-845-4500",
            "fax_number": "214-845-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N PECK RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601751043",
            "telephone_number": "630-485-4510",
            "fax_number": "630-485-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-845-4500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "5103970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Charles Plastic Surgery, LTD.
• St Charles Skilled Nursing Facility LLC (The Grove of St Charles)
• St. Charles Family Dentristry L.T.D.
• St. Charles Family Medical Center, SC
• St. Charles Foot and Ankle Center PC
• St. Charles Modern Dental, LLC
• St. Charles NH LLC (River Crossing of St. Charles)
• St. Charles Pain and Wellness Center, LLC
• St. Charles Podiatry Assoc
• St. Charles Service Corporation (Olympia Chiropractic and Physical Therapy)

• Assisted Living Facility in St Charles, IL
• Providers in St Charles, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.