Boone County Council on Aging

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BOONE COUNTY COUNCIL ON AGING

Practice address

2141 Henry Luckow LN
Belvidere, IL 61008-1700

Phone

(815) 544-9893

Fax

(815) 547-7373

NPI assigned

Sep 30, 2013

Last updated

Sep 30, 2013By 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

Mr. Joe Fortmann

Title

Executive Director

Phone

(815) 544-9893

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Boone County Council on Aging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Boone County Council on Aging

  • Bus
  • Belvidere, IL
  • NPI 1881900678
  NPD tax ID

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1407283906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081700",
            "telephone_number": "815-544-9893",
            "fax_number": "815-547-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081700",
            "telephone_number": "815-544-9893",
            "fax_number": "815-547-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE COUNTY COUNCIL ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "FORTMANN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-544-9893",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS CCP CONTRACT",
            "identifier": "INH1001001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Anne Bennett, PHARMD
• Lora Ethelyn Bertell, PHARMD
• Alfredo Daniel Bizzocchi
• Jeremiah Blaser, PT, DPT
• Board of Trustees of the University of Illinois (University Primary Care Clinic at Belvidere)
• Boone County Council on Aging
• Boone County Rural Fire Protection District Number Two
• Boone County Special Ed Coop
• Boone County Special Ed Coop
• Ryen Bostick, DPT

• In Home Supportive Care Agency in Belvidere, IL
• Providers in Belvidere, IL by specialty
• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.