NPIMap

Organization Active NPI

Genesis

  • Skilled Nursing Facility
  • Chicago, IL
National Provider Identifier
1386911600
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
146010384 Issued in IL
Legal business name
GENESIS
Practice address
3400 S Indiana Ave
Chicago, IL 60616-3841
Phone
(312) 842-5000
NPI assigned
Dec 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Anna Dorothea Mueller
Title
Speech-Language Pathologist
Phone
(616) 520-3959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 146010384 IL Primary

Addresses

Primary practice location

3400 S Indiana Ave
Chicago, IL 60616-3841

Mailing address

1512 W School St
Apt 2
Chicago, IL 60657-9536

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1386911600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W SCHOOL ST",
            "address_2": "APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S INDIANA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163841",
            "telephone_number": "312-842-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "DOROTHEA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "616-520-3959"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "146010384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.