Forum Extended Care Services of Central Illinois

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

054020139 Issued in IL

Legal business name

FORUM EXTENDED CARE SERVICES OF CENTRAL ILLINOIS

Doing business as

Forum Extended Care Services of Central Illinois

Practice address

2205 Wabash Ave Ste 211
Springfield, IL 62704-5356

Phone

(847) 673-8727

Fax

(847) 673-6215

NPI assigned

Jun 16, 2016

Organization subpart

No

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

Authorized official

Name

Brian KramerNPI 1134217623

Title

President

Phone

(847) 673-8727

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Forum Extended Care Services of Central Illinois Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Forum Extended Care SVC Inc II

  • Long Term Care Pharmacy
  • Chicago, IL
  • NPI 1346291499

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian H Kramer, R.PH.

  • Pharmacist
  • Chicago, IL
  • NPI 1134217623
  NPD Authorized official

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1689024036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W VICTORIA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466700",
            "telephone_number": "847-673-8727",
            "fax_number": "847-673-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 WABASH AVE STE 211",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045356",
            "telephone_number": "847-673-8727",
            "fax_number": "847-673-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORUM EXTENDED CARE SERVICES OF CENTRAL ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2022-01-31",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-673-8727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054020139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160632",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forum Extended Care Services of Central Illinois",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forum Extended Care Services of Central Illinois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicolas A. Forero, M.D.
• Stephanie Forgas, LCPC
• Shawna Megan Forinash, LCSW
• Megan J Forshee, D.O.
• Fort Health Medical Group PA
• Angela Fay Foshage Johnson, O.D.
• Eliane Fossatti Goncalves, DDS
• Michaelia Vasilia Fosses Vuong, DO
• Anne O'Brien Foster, NP-C
• Ashlee Foster, FNP

• Long Term Care Pharmacy in Springfield, IL
• Providers in Springfield, IL by specialty
• Long Term Care Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.