Autumn Country Club, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

AUTUMN COUNTRY CLUB, INC.

Doing business as

Autumn Adult Day Care

Practice address

107 N Reed St
Joliet, IL 60435-6825

Phone

(815) 730-0060

Fax

(815) 741-0943

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Ms. M Catherine Waterman

Title

Program Director

Phone

(815) 730-0060

Specialties & licenses 2

Addresses

Other names 1

• Autumn Adult Day Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise Petenzi, DPM

  • Podiatrist
  • Chicago, IL
  • NPI 1457329708
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1376590810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N REED ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356825",
            "telephone_number": "815-730-0060",
            "fax_number": "815-741-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N REED ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356825",
            "telephone_number": "815-730-0060",
            "fax_number": "815-741-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN COUNTRY CLUB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "M CATHERINE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "815-730-0060",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "IL",
            "license": "ADS1102001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Adult Day Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in Joliet, IL
• Providers in Joliet, IL by specialty
• Adult Day Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.