Shabbona Health Care Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

19743841 Issued in IL

Legal business name

SHABBONA HEALTH CARE CENTER

Practice address

409 W Comanche Ave
Shabbona, IL 60550-9790

Phone

(815) 824-2194

Fax

(815) 824-2188

NPI assigned

Nov 11, 2005

Last updated

Oct 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Moe Herman

Title

Comptroller

Phone

(847) 982-2300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1629059035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7434 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773341",
            "telephone_number": "847-982-2300",
            "fax_number": "847-982-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W COMANCHE AVE",
            "city": "SHABBONA",
            "state": "IL",
            "postal_code": "605509790",
            "telephone_number": "815-824-2194",
            "fax_number": "815-824-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHABBONA HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "MOE",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "847-982-2300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "19743841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Progress, Inc. (dba Kish Health Family Care)
• Indian Creek Cusd 425
• Prairie Crossing Assisted Living, LLC
• Prairie Crossing Living & Rehabilitation Center, LLC
• Shabbona Comm Fire District
• Shabbona Helath Care Center
• Shabbona Supportive Living (none)
• Shabbona Supportive Living
• Leslie Ward, M.A., SLP

• Skilled Nursing Facility in Shabbona, IL
• Providers in Shabbona, 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 Oct 13, 2009; 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.