Paradox Decatur Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARADOX DECATUR OPERATOR LLC

Practice address

444 W Harrison Ave
Decatur, IL 62526-4157

Phone

(217) 877-7333

NPI assigned

Dec 5, 2018

Organization subpart

No

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

Authorized official

Name

Mr. William Rothner

Title

Manager

Phone

(847) 905-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Decatur Living Center Doing business as

Locations

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1508337338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122628",
            "telephone_number": "847-675-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W HARRISON AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264157",
            "telephone_number": "217-877-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADOX DECATUR OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "ROTHNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-905-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPARTMENT PUBLIC HEALTH",
            "identifier": "0055418",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Decatur, IL
• Providers in Decatur, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.