Kindred THC Chicago, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

0004952 Issued in IL

Legal business name

KINDRED THC CHICAGO, LLC

Doing business as

Kindred Hospital - Chicago

Practice address

365 E North Ave
Northlake, IL 60164

Phone

(708) 345-8100

Fax

(708) 345-0470

NPI assigned

Oct 25, 2006

Last updated

May 6, 2019By 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

Mr. Terrance K. Dillon

Title

Assistant Secretary

Phone

(502) 596-7220

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kindred Hospital - Chicago Doing business as

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1679658132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 E NORTH AVE",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601642628",
            "telephone_number": "708-345-8100",
            "fax_number": "708-345-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 E NORTH AVE",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "60164",
            "telephone_number": "708-345-8100",
            "fax_number": "708-345-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED THC CHICAGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "IL",
            "license": "0004952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "106",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Hospital - Chicago",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospital - Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Jacob
• Adiba Jagirdar, DMD
• Heather Jandura, LCSW
• Kindred Chicago Northlake, LLC (Kindred Hospital - Chicago (Northlake Campus))
• Kindred Healthcare Operating, LLC
• Garrett Adam Klein, D.C.
• Jessica Knapp
• KND Development 59 LLC
• Jonathan Kye, PHARMD
• Ellen Locke

• Long Term Care Hospital in Northlake, IL
• Providers in Northlake, IL by specialty
• Long Term Care Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.