Illinois Skilled Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ILLINOIS SKILLED CARE, LLC

Practice address

202 S Greenleaf St
Suite C
Gurnee, IL 60031-3399

Phone

(847) 360-7660

Fax

(847) 360-8411

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Lora Mantelman

Title

Administrator

Phone

(847) 360-7660

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570147200000",
    "number": "1790056018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S GREENLEAF ST STE C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313399",
            "telephone_number": "847-360-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S GREENLEAF ST",
            "address_2": "SUITE C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313399",
            "telephone_number": "847-360-7660",
            "fax_number": "847-360-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS SKILLED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2019-10-04",
        "status": "A",
        "authorized_official_last_name": "MANTELMAN",
        "authorized_official_first_name": "LORA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-360-7660"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.