Woodbridge Nursing Pavilion, LTD.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0034157 Issued in IL

Legal business name

WOODBRIDGE NURSING PAVILION, LTD.

Practice address

2242 N Kedzie Blvd
Chicago, IL 60647-2504

Phone

(773) 486-7700

Fax

(773) 486-7937

NPI assigned

Dec 26, 2005

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1821075474",
    "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",
            "fax_number": "847-679-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 N KEDZIE BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472504",
            "telephone_number": "773-486-7700",
            "fax_number": "773-486-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE NURSING PAVILION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-26",
        "last_updated": "2011-11-23",
        "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": "0034157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leana Woodard
• Maggie Michelle Woodard
• Tiara Nicole Woodard, FNP, APRN
• Tony Woodard, MA, NCC, CADC
• Madeline Woodberry
• Emily Woodcock
• Nicole Woodcox Bolden, LCSW
• Cassandra Wooden-Seawood
• Ashley Wooden
• Woodfern Psychotherapy LLC

• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, 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 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.