Bayside Care Center LP

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

Legal business name

BAYSIDE CARE CENTER LP

Practice address

1100 S Lewis Ave
Waukegan, IL 60085-7710

Phone

(847) 244-8196

NPI assigned

Jan 30, 2025

Organization subpart

No

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

Authorized official

Name

Kim M Boulton

Title

Contract Coordinator

Phone

(847) 933-9200

Specialties & licenses 1

Addresses

Other names 1

• Bayside Care Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1407669674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771123",
            "telephone_number": "847-933-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S LEWIS AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600857710",
            "telephone_number": "847-244-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE CARE CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "BOULTON",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CONTRACT COORDINATOR",
        "authorized_official_telephone_number": "847-933-9200"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jean Barron, CNM
• April Renee Barroso
• Weston John Bartsch, DPT
• Barwell Dental Clinic, Inc.
• Satish Batchu, MD
• Bayside Terrace LLC
• Tahar Baziz
• Ouida Beard
• Kori Dawn Beckman
• Laura Behrensmeier

• Mental Illness Intermediate Care Facility in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Mental Illness Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.