Organization Active NPI

Park Ridge Care Center, LTD.

  • Skilled Nursing Facility
  • Park Ridge, IL
National Provider Identifier
1477530426
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0039255 Issued in IL
Legal business name
PARK RIDGE CARE CENTER, LTD.
Practice address
665 Busse Hwy
Park Ridge, IL 60068-2523
Phone
(847) 825-5517
Fax
(847) 825-5596
NPI assigned
Dec 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Mr. Marshall A Mauer
Title
Asst Secretary
Phone
(847) 679-8219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0039255 IL Primary

Addresses

Primary practice location

665 Busse Hwy
Park Ridge, IL 60068-2523

Mailing address

3359 Main St
Skokie, IL 60076-2432

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1477530426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 BUSSE HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682523",
            "telephone_number": "847-825-5517",
            "fax_number": "847-825-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE CARE CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASST SECRETARY",
        "authorized_official_telephone_number": "847-679-8219",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0039255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.