NPIMap

Organization Active NPI

Marklund Mill Creek Home 3

  • Intellectual Disabilities Intermediate Care Facility
  • Geneva, IL
National Provider Identifier
1760649966
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
000047258 Issued in IL
Legal business name
MARKLUND MILL CREEK HOME 3
Practice address
1S381 Wyatt Dr
Geneva, IL 60134-4921
Phone
(630) 593-5500
NPI assigned
May 16, 2008
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MARKLUND CHILDRENS HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Mr. Joel Rusco
Title
Ceo/President
Phone
(630) 593-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 000047258 IL Primary

Addresses

Primary practice location

1S381 Wyatt Dr
Geneva, IL 60134-4921

Mailing address

1S450 Wyatt Dr
Geneva, IL 60134-4921
Phone (360) 593-5500

National Provider Directory

National Provider Directory
Tax ID family
Marklund Richard Home11 organizations share this tax ID, including this one
Part of
Marklund Richard Home

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1760649966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S450 WYATT DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344921",
            "telephone_number": "360-593-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S381 WYATT DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344921",
            "telephone_number": "630-593-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKLUND MILL CREEK HOME 3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARKLUND CHILDRENS HOME",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "RUSCO",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "630-593-5500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "000047258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.