NPIMap

Organization Active NPI

Fountains Crystal Lake SL LLC

  • Skilled Nursing Facility
  • Crystal Lake, IL
National Provider Identifier
1720031156
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0047217 Issued in IL
Legal business name
FOUNTAINS CRYSTAL LAKE SL LLC
Practice address
1000 E Brighton LN
Crystal Lake, IL 60012-2074
Phone
(815) 455-8400
Fax
(815) 477-6502
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Authorized official

Name
Greta Fruhling Frazier
Title
Director
Phone
(520) 797-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0047217 IL Primary

Addresses

Primary practice location

1000 E Brighton LN
Crystal Lake, IL 60012-2074

Mailing address

965 N Brighton Cir
Crystal Lake, IL 60012-2036
Phone (815) 455-8400

Other names 1

  • FOUNTAINS AT CRYSTAL LAKE Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1720031156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 N BRIGHTON CIR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122036",
            "telephone_number": "815-455-8400",
            "fax_number": "815-477-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E BRIGHTON LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122074",
            "telephone_number": "815-455-8400",
            "fax_number": "815-477-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAINS CRYSTAL LAKE SL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "GRETA",
        "authorized_official_middle_name": "FRUHLING",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-797-4000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0047217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUNTAINS AT CRYSTAL LAKE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.