NPIMap

Organization Active NPI

Marianjoy at Providence Palos Heights

  • Skilled Nursing Facility
  • Palos Heights, IL
National Provider Identifier
1649404245
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARIANJOY AT PROVIDENCE PALOS HEIGHTS
Practice address
13259 S Central Ave
Palos Heights, IL 60463-2601
Phone
(630) 909-7378
Fax
(630) 909-7371
NPI assigned
May 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Authorized official

Name
Jacque' Barnes
Title
Patient Account Manager
Phone
(603) 909-7378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

13259 S Central Ave
Palos Heights, IL 60463-2601

Mailing address

13259 S Central Ave
Palos Heights, IL 60463-2601
Phone (630) 909-7378

Other identifiers 1

IdentifierTypeStateIssuer
50426OtherILBLUE CROSS BLUE SHIELD ILLINOIS

National Provider Directory

National Provider Directory
Tax ID family
Marianjoy Rehab Hosp NE5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1649404245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13259 S CENTRAL AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632601",
            "telephone_number": "630-909-7378",
            "fax_number": "630-909-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13259 S CENTRAL AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632601",
            "telephone_number": "630-909-7378",
            "fax_number": "630-909-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANJOY AT PROVIDENCE PALOS HEIGHTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JACQUE'",
        "authorized_official_title_or_position": "PATIENT ACCOUNT MANAGER",
        "authorized_official_telephone_number": "603-909-7378"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ILLINOIS",
            "identifier": "50426",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.