Organization Active NPI

Fairview Care Center of Joliet, LLC

  • Skilled Nursing Facility
  • Chicago, IL
National Provider Identifier
1750589388
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FAIRVIEW CARE CENTER OF JOLIET, LLC
Practice address
3553 W Peterson Ave # 40
Chicago, IL 60659-3200
Phone
(773) 509-0027
NPI assigned
Jul 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Yosef Meystel
Title
Manager
Phone
(773) 509-0027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3553 W Peterson Ave # 40
Chicago, IL 60659-3200

Mailing address

3553 W Peterson Ave # 40
Chicago, IL 60659-3200

Other identifiers 1

IdentifierTypeStateIssuer
208047008001MedicaidIL

National Provider Directory

National Provider Directory

Locations

3553 W Peterson Ave
#40
Chicago, IL 60659
Phone (773) 509-0027

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750589388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 W PETERSON AVE # 40",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3553 W PETERSON AVE # 40",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593200",
            "telephone_number": "773-509-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW CARE CENTER OF JOLIET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYSTEL",
        "authorized_official_first_name": "YOSEF",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-509-0027"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208047008001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.