Wyndemere LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0050674 Issued in IL

Legal business name

WYNDEMERE LLC

Practice address

2180 Manchester Rd
Wheaton, IL 60187-4580

Phone

(630) 681-4200

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Judi L Buxo

Title

Sr Vice President

Phone

(515) 875-4500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Wyndemere Doing business as

Locations

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1497723464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MANCHESTER RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874580",
            "telephone_number": "630-681-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 MANCHESTER RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874580",
            "telephone_number": "630-681-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDEMERE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "BUXO",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "515-875-4500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "0050674",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "41426",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363436685002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyndemere",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Wright
• Patrisha I Wright
• Carol B. Wrigt, LCPC
• Hsin Wu
• Daniel Robert Wyma, MD
• Wyndemere Senior Care, LLC
• Renee M Yackey, PT
• Natalia I Yangarber-Hicks, PH.D.
• James R Yanke, PA-C
• Christine Yates

• Assisted Living Facility in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.