Maple Lawn Health Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MAPLE LAWN HEALTH CENTER

Practice address

700 N Main St
Eureka, IL 61530-1085

Phone

(309) 467-2337

Fax

(309) 467-9011

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jordan T Post

Title

Administrator

Phone

(309) 467-9059

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

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

• Kendra Mickelson

  • Skilled Nursing Facility
  • Eureka, IL
  • NPI 1992158356
  NPD

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1720073414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N MAIN ST",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301085",
            "telephone_number": "309-467-2337",
            "fax_number": "309-467-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N MAIN ST",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301085",
            "telephone_number": "309-467-2337",
            "fax_number": "309-467-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LAWN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "POST",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-467-9059",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1694647",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0042424",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042424",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Ellen Kolb, COTA
• Toni Marie Lais, P.T.
• Tomislav Lakic, MD
• Eric John Larson, EL CADC BS
• Monica Malcome, LMT
• Maple Lawn Homes Inc.
• Joy Martin
• Michael S Borzello DDS LTD
• Kendra Mickelson
• Alexa Miller

• Skilled Nursing Facility in Eureka, IL
• Providers in Eureka, 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 Nov 1, 2016; 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.