NPIMap

Organization Active NPI

Renaissance Care Center, Inc

  • Pediatric Skilled Nursing Facility
  • Canton, IL
National Provider Identifier
1801288915
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
0040295 Issued in IL
Legal business name
RENAISSANCE CARE CENTER, INC
Practice address
1675 E Ash St
Canton, IL 61520-1510
Phone
(309) 647-5631
Fax
(309) 647-8957
NPI assigned
Feb 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Authorized official

Name
Bradley Alter
Title
Ceo
Phone
(847) 674-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 0040295 IL Primary

Addresses

Primary practice location

1675 E Ash St
Canton, IL 61520-1510

Mailing address

3856 Oakton St
Suite 200
Skokie, IL 60076-3454
Phone (847) 674-4700

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Care Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1801288915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3856 OAKTON ST",
            "address_2": "SUITE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763454",
            "telephone_number": "847-674-4700",
            "fax_number": "874-674-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E ASH ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615201510",
            "telephone_number": "309-647-5631",
            "fax_number": "309-647-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "ALTER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-674-4700"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "IL",
            "license": "0040295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.