Active NPI
Park Ridge Care Center, LTD.
- Skilled Nursing Facility
- Park Ridge, IL
National Provider Identifier
1477530426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0039255
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.