McLean County Assisted Living, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MCLEAN COUNTY ASSISTED LIVING, L.L.C.

Practice address

1701 Evergreen Village Blvd
Normal, IL 61761

Phone

(309) 452-7300

Fax

(309) 452-7311

NPI assigned

Feb 27, 2008

Organization subpart

Yes

Parent organization

MCLEAN COUNTY ASSISTED LIVING, L.L.C.As reported in NPPES

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

Authorized official

Name

Mr. Craig L. Ater

Title

Senior V. P. of Finance

Phone

(309) 823-7135

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Village Supportive Living, L.L.C. Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

McLean County Assisted Living LLC2 organizations share this tax ID, including this one

Part of

McLean County Assisted Living LLC

Other organizations with this tax ID 1

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

• McLean County Assisted Living Facility, L.L.C.

  • Assisted Living Facility
  • Normal, IL
  • NPI 1447429378
  NPD tax ID

Locations

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1629247283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W JEFFERSON ST",
            "address_2": "SUITE 401, PO BOX 3188",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013946",
            "telephone_number": "309-823-7155",
            "fax_number": "309-829-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 EVERGREEN VILLAGE BLVD",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-452-7300",
            "fax_number": "309-452-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN COUNTY ASSISTED LIVING, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEAN COUNTY ASSISTED LIVING, L.L.C.",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "ATER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR V. P. OF FINANCE",
        "authorized_official_telephone_number": "309-823-7135",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205051684001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Village Supportive Living, L.L.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise A McGuffin, MD
• Adam Joseph McKillip, PA-C
• Mattie McKinney, M.S., CCC-SLP
• Ryan Joseph McLaughlin, DC
• McLean County Assisted Living Facility, L.L.C.
• McLean County Eye Center, PC
• McLean County Nursing Home
• McLean County Nursing Home
• McLean County Unit District #5
• Todd A McLoda, PHD, ATC

• Assisted Living Facility in Normal, IL
• Providers in Normal, 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 Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.