Park Lawn Center

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0027078 Issued in IL

Legal business name

PARK LAWN CENTER

Practice address

10833 Laporte Ave
Oak Lawn, IL 60453-5412

Phone

(708) 425-3344

Fax

(708) 425-3530

NPI assigned

Sep 27, 2010

Last updated

Sep 27, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

PARK LAWN SCHOOL & ACTIVITY CENTER, INCAs reported in NPPES

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

Authorized official

Name

Mr. James R. Weise

Title

Executive Director

Phone

(708) 425-3344

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Park Lawn School Activity Center Inc3 organizations share this tax ID, including this one

Part of

Park Lawn School Activity Center Inc

Other organizations with this tax ID 2

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

• Park Lawn Home

  • Intellectual Disabilities Intermediate Care Facility
  • Oak Lawn, IL
  • NPI 1285943134
  NPD tax ID
• Park Lawn School & Activity Center, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oak Lawn, IL
  • NPI 1609094788
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Park Lawn School & Activity Center, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oak Lawn, IL
  • NPI 1609094788
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lora Kosivzoff, D.P.M.

  • Podiatrist
  • Chicago, IL
  • NPI 1740315472
  NPD (past)

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1467761312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 W 115TH ST",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608035150",
            "telephone_number": "708-396-1117",
            "fax_number": "708-396-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LAPORTE AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535412",
            "telephone_number": "708-425-3344",
            "fax_number": "708-425-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK LAWN CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK LAWN SCHOOL & ACTIVITY CENTER, INC",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "WEISE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-425-3344",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0027078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0027078",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Stanley Para, MD
• Manuel Alberto Paredes Flores, MD
• Eva Alicia Paredes, OTR/L
• Trupti R Parikh, CPNP-PC
• Nicole Paris, BCBA
• Park Lawn Home
• Park Lawn School & Activity Center, Inc.
• Michelle Park-Huang
• Jimmy K Park, MD
• Ashley Denise Parker-Shearer

• Intellectual Disabilities Intermediate Care Facility in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Intellectual Disabilities Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.