Our Lady of Angels Retirement Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OUR LADY OF ANGELS RETIREMENT HOME

Practice address

1201 Wyoming Ave
Joliet, IL 60435-3718

Phone

(815) 725-6631

Fax

(815) 725-1451

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

George Block

Title

Administrator

Phone

(815) 725-6631

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1790787679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 WYOMING AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353718",
            "telephone_number": "815-725-6631",
            "fax_number": "815-725-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WYOMING AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353718",
            "telephone_number": "815-725-6631",
            "fax_number": "815-725-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF ANGELS RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "BLOCK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-725-6631"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Joliet, IL
• Providers in Joliet, 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 Nov 7, 2016; 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.