Manor Care of Hinsdale Il, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0027482 Issued in IL

Legal business name

MANOR CARE OF HINSDALE IL, LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Hinsdale)

Practice address

600 W Ogden Ave
Hinsdale, IL 60521-3158

Phone

(630) 325-9630

Fax

(630) 325-9648

NPI assigned

Jun 4, 2006

Last updated

Feb 28, 2023By 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. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Hinsdale) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1710925177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213158",
            "telephone_number": "630-325-9630",
            "fax_number": "630-325-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF HINSDALE IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0027482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Hinsdale)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaleem Malik, M.D.
• Nida Malik, DO
• Sarah Malik, PA-C
• Thomas Venkat Mallidi, MD
• Ryan Walker Mannion, OD
• Jolene K Manuyag
• Jacqueline Lee Marchbank, APN
• Erin Marek-Krawczyk, PSY.D.
• Margo Tirado Ma, LCPC, LTD.
• Heather Marino, C.N.P.

• Skilled Nursing Facility in Hinsdale, IL
• Providers in Hinsdale, 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 Feb 28, 2023; 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.