NPIMap

Organization Active NPI

Pioneer Concepts Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Sauk Village, IL
National Provider Identifier
1497928618
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
47977 Issued in IL
Legal business name
PIONEER CONCEPTS INC
Practice address
1641 Carole Lane
Sauk Village, IL 60411-4990
Phone
(708) 758-8756
Fax
(708) 758-1817
NPI assigned
Apr 9, 2008
Organization subpart
Yes
Parent organization
PIONEER CONCEPTS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Ronald J Wilson
Title
Authorized Agent
Phone
(309) 343-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 47977 IL Primary

Addresses

Primary practice location

1641 Carole Lane
Sauk Village, IL 60411-4990

Mailing address

285 South Farnham Street
Galesburg, IL 61401-5323
Phone (309) 343-1550

Other names 1

  • Carole Lane Terrace Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pioneer Concepts Inc13 organizations share this tax ID, including this one
Part of
Pioneer Concepts Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1641 Carole Ln
Sauk Village, IL 60411
Phone (708) 758-8756

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1497928618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SOUTH FARNHAM STREET",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015323",
            "telephone_number": "309-343-1550",
            "fax_number": "309-343-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 CAROLE LANE",
            "city": "SAUK VILLAGE",
            "state": "IL",
            "postal_code": "604114990",
            "telephone_number": "708-758-8756",
            "fax_number": "708-758-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER CONCEPTS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIONEER CONCEPTS INC",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "47977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carole Lane Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sauk Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.