Willow Crest Nursing Pavillion, LTD.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0036533 Issued in IL

Legal business name

WILLOW CREST NURSING PAVILLION, LTD.

Practice address

515 N Main St
Sandwich, IL 60548-1253

Phone

(815) 786-8426

Fax

(815) 786-1621

NPI assigned

Dec 28, 2005

Last updated

Aug 31, 2011By 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. Marshall A Mauer

Title

Secretary/Treasurer

Phone

(847) 679-8219

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1780661165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481253",
            "telephone_number": "815-786-8426",
            "fax_number": "815-786-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481253",
            "telephone_number": "815-786-8426",
            "fax_number": "815-786-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREST NURSING PAVILLION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "847-679-8219",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0036533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Wasson, PT
• John Stuart Waters, D.D.S.
• Brenda Weilert
• Mark Donald Weinhold, D.D.S.
• Ann Luise West, MD
• Sophia Winckler, MS, CF-SLP
• Stephanie Winn, WHNP
• Wolski Dental Group PC
• Blair Elise Wright, MD
• Nicole L Wright, RPH

• Skilled Nursing Facility in Sandwich, IL
• Providers in Sandwich, 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 Aug 31, 2011; 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.