CC Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CC CARE LLC

Practice address

4314 S Wabash Ave
Chicago, IL 60653-3119

Phone

(773) 538-8300

Fax

(773) 538-5775

NPI assigned

Feb 6, 2012

Organization subpart

Yes

Parent organization

JLM FINANCIAL HEALTHCARE, LPAs reported in NPPES

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

Authorized official

Name

Mr. Jamie Nickle

Title

Director

Phone

(630) 501-0996

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Community Care Center Doing business as

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1629340690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 S WABASH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533119",
            "telephone_number": "773-538-8300",
            "fax_number": "773-538-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 S WABASH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533119",
            "telephone_number": "773-538-8300",
            "fax_number": "773-538-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JLM FINANCIAL HEALTHCARE, LP",
        "enumeration_date": "2012-02-06",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "NICKLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-501-0996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051722",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, 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 Aug 24, 2016; 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.