NPIMap

Organization Active NPI

Victory Centre of River Woods

  • Assisted Living Facility
  • Melrose Park, IL
National Provider Identifier
1487821260
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
364273297004 Issued in IL
Legal business name
VICTORY CENTRE OF RIVER WOODS
Practice address
1800 Riverwoods Dr
Melrose Park, IL 60160-1639
Phone
(708) 547-5800
Fax
(708) 345-7458
NPI assigned
May 12, 2008
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PATHWAY SENIOR LIVING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Ellie Baum
Title
Executive Director
Phone
(708) 547-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 364273297004 IL Primary

Addresses

Primary practice location

1800 Riverwoods Dr
Melrose Park, IL 60160-1639

Mailing address

1800 Riverwoods Dr
Melrose Park, IL 60160-1639
Phone (708) 547-5800

Other identifiers 1

IdentifierTypeStateIssuer
364273297004MedicaidIL

National Provider Directory

National Provider Directory
Part of
Pathway Senior Living LLC

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1487821260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 RIVERWOODS DR",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601639",
            "telephone_number": "708-547-5800",
            "fax_number": "708-345-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 RIVERWOODS DR",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601639",
            "telephone_number": "708-547-5800",
            "fax_number": "708-345-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY CENTRE OF RIVER WOODS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAY SENIOR LIVING LLC",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "BAUM",
        "authorized_official_first_name": "ELLIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-547-5800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "364273297004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364273297004",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.