Organization Active NPI

Warren Park Nursing Pavilion, LTD.

  • Skilled Nursing Facility
  • Chicago, IL
National Provider Identifier
1780661348
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0036079 Issued in IL
Legal business name
WARREN PARK NURSING PAVILION, LTD.
Practice address
6700 N Damen Ave
Chicago, IL 60645-4902
Phone
(773) 465-5000
NPI assigned
Dec 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0036079 IL Primary

Addresses

Primary practice location

6700 N Damen Ave
Chicago, IL 60645-4902

Mailing address

3359 Main St
Skokie, IL 60076-2432
Phone (847) 679-8219

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1780661348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762432",
            "telephone_number": "847-679-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454902",
            "telephone_number": "773-465-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN PARK NURSING PAVILION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-26",
        "last_updated": "2011-08-19",
        "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": "0036079",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 19, 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.