LTC Practitioners of Illinois

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

209009340 Issued in IL

Legal business name

LTC PRACTITIONERS OF ILLINOIS

Practice address

3915 N. Kenneth Ave.
Chicago, IL 60641-2816

Phone

(773) 401-4412

Fax

(312) 492-6269

NPI assigned

Apr 19, 2012

Organization subpart

No

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

Authorized official

Name

Sue E. Wilson, APN

Title

Nurse Practitioner

Phone

(773) 401-4412

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lory Joanna Arquilla-Maltby, NP

  • Adult Health Nurse Practitioner
  • Elmwood Park, IL
  • NPI 1205866373
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1821355561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 N KENNETH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412816",
            "telephone_number": "773-401-4412",
            "fax_number": "312-492-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 N. KENNETH AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412816",
            "telephone_number": "773-401-4412",
            "fax_number": "312-492-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC PRACTITIONERS OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "773-401-4412",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "209009340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LS Surgery Center LTD
• Lsa Limited Partnership
• LSF PT LLC
• LT Therapy PLLC
• LTC Dental, LLC
• Lte Preventive Health Systems, Inc.
• Lu Rocha Counseling Services PC
• Lu Rocha Counseling Services PC
• Alan Michael Lu, APRN, CRNA
• Alexander Lu, MD

• 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 Apr 19, 2012; 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.