The Old People'S Home of the City of Chicago

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

THE OLD PEOPLE'S HOME OF THE CITY OF CHICAGO

Practice address

909 W Foster Ave
Chicago, IL 60640-6481

Phone

(773) 654-5077

Fax

(773) 561-2573

NPI assigned

Dec 31, 2006

Organization subpart

No

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Helen Dittmer, MSN, DNS-CT, RN

  • Gerontology Registered Nurse
  • Rockford, IL
  • NPI 1720657190
  NPD

Tax ID family

Admiral at the Lake2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Admiral at the Lake

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1982946604
  NPD tax ID

Locations

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

Authorized official

Name

Dr. Glenn Brichacek, PH.D.

Title

President/Ceo

Phone

(773) 561-2900

Specialties & licenses 1

Addresses

Other names 1

• The Admiral at the Lake Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508922683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131214",
            "telephone_number": "773-561-2900",
            "fax_number": "773-561-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606406481",
            "telephone_number": "773-654-5077",
            "fax_number": "773-561-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OLD PEOPLE'S HOME OF THE CITY OF CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRICHACEK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-561-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Admiral at the Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Chicago, IL
• Nursing Facility/Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.