Manor Care of Oak Lawn (West) Il, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0027540 Issued in IL

Legal business name

MANOR CARE OF OAK LAWN (WEST) IL, LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Oak Lawn West)

Practice address

6300 W 95TH St
Oak Lawn, IL 60453-2256

Phone

(708) 599-8800

Fax

(708) 599-8820

NPI assigned

Jun 14, 2006

Last updated

Feb 28, 2023By 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. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Oak Lawn West) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1437192879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532256",
            "telephone_number": "708-599-8800",
            "fax_number": "708-599-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF OAK LAWN (WEST) IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0027540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Oak Lawn West)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Oak Lawn West)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn Wassberg Manley, LCPC
• Amr Mannaa
• Sarah Tierney Manning, PA-C
• Scherry Manning
• Manor Care of Oak Lawn (East) Il, LLC (ProMedica Skilled Nursing and Rehabilitation (Oak Lawn East))
• Madeline E. Manske, SLP
• Sheena Agarwal Mansukhani, D.O.
• Lifang Mao, MD
• Sonja Marcic, MD
• Ahmad Mardini

• Skilled Nursing Facility in Oak Lawn, IL
• Providers in Oak Lawn, 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 28, 2023; 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.