Bourbonnais Terrace Operator LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0021550 Issued in IL

Legal business name

BOURBONNAIS TERRACE OPERATOR LLC

Practice address

133 Mohawk Dr
Bourbonnais, IL 60914-1349

Phone

(815) 937-4790

Fax

(815) 937-0432

NPI assigned

Oct 6, 2006

Last updated

Aug 22, 2020By 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. Avrum Weinfeld

Title

Cfo

Phone

(847) 674-5795

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• bourbonnais terrace Former legal business name

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760579163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124611",
            "telephone_number": "847-674-5795",
            "fax_number": "847-674-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MOHAWK DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141349",
            "telephone_number": "815-937-4790",
            "fax_number": "815-937-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOURBONNAIS TERRACE OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINFELD",
        "authorized_official_first_name": "AVRUM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-674-5795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0021550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021550",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "bourbonnais terrace",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Bourbonnais Chiropractic LTD
• Bourbonnais Elementary District 53
• Bourbonnais Fire District
• Bourbonnais Sleep Solutions LLC
• Bourbonnais Sleep Solutions LLC (Bourbonnais Sleep Solutions)
• Kathryn Bozinovich, PT
• Bradley Dental, LLC
• Patricia Lynn Brady
• Brandon Douglas, LCPC, PLLC
• Brent Dunlap OD PC (DRS Long & Dunlap)

• Nursing Facility/Intermediate Care Facility in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Nursing Facility/Intermediate Care Facility in Illinois

• 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.