KT Care LLC

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

Legal business name

KT CARE LLC

Doing business as

Kankakee Terrace Nursing Center

Practice address

100 Belle Aire Ave
Bourbonnais, IL 60914-2006

Phone

(815) 939-0910

Fax

(815) 939-0973

NPI assigned

Jan 23, 2012

Organization subpart

Yes

Parent organization

JLM FINANCIAL HEALTHCARE, LPAs reported in NPPES

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

Authorized official

Name

Mr. Jamie Nickle

Title

Director

Phone

(630) 501-0996

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kankakee Terrace Nursing Center Doing business as

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1477824480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S443 SUMMIT AVE",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813989",
            "telephone_number": "847-767-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BELLE AIRE AVE",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142006",
            "telephone_number": "815-939-0910",
            "fax_number": "815-939-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KT CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JLM FINANCIAL HEALTHCARE, LP",
        "enumeration_date": "2012-01-23",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "NICKLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-501-0996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051680",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kankakee Terrace Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amber Kruchten
• Chelsea Krug, DPT
• Craig Kuchenthal
• Ahamed V.P. Kutty, M.D.
• Marina A Kuznetsova, M.D.
• Grazelda Kwakye-Ackah, MD
• Cassandra J Lacher, DO

• Mental Illness Intermediate Care Facility in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Mental Illness Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.