Deerbrook Care Center LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

40741 Issued in IL

Legal business name

DEERBROOK CARE CENTER LP

Practice address

306 N Larkin Ave
Joliet, IL 60435-6698

Phone

(815) 744-5560

Fax

(815) 744-6914

NPI assigned

Dec 20, 2005

Last updated

Feb 20, 2012By 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. Michael Charles Braun

Title

Controller

Phone

(847) 583-0100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1427034651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N LARKIN AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356698",
            "telephone_number": "815-744-5560",
            "fax_number": "815-744-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N LARKIN AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356698",
            "telephone_number": "815-744-5560",
            "fax_number": "815-744-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERBROOK CARE CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "847-583-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "40741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH LICENSE NUMBER",
            "identifier": "40741",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH FACILITY NUMBER",
            "identifier": "6002463",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alishia Davison, PA-C
• Clyde Dawson, M.D.
• Tuesday Dawson, MSW
• Tania Decker
• Carley Decore
• Carrie Defuss
• Esteysi Dejesus
• Natalie Delarosa, RBT
• Lorena Ulloa Delgado
• Kimberly Delp, NP

• Skilled Nursing Facility in Joliet, IL
• Providers in Joliet, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.