Active NPI
Presbyterian Homes
- Medical Specialty Clinic/Center
- Lake Forest, IL
National Provider Identifier
1831169945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- 0044065
- Legal business name
- PRESBYTERIAN HOMES
- Practice address
- 1100 Pembridge Dr
Lake Forest, IL 60045 - Phone
- (847) 604-6700
- Fax
- (847) 604-6604
- NPI assigned
- Jan 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert E Landsman
- Title
- Vice President of Finance
- Phone
- (847) 492-4859
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 0044065 | IL | Primary |
| Assisted Living Facility | 310400000X | 0044065 | IL | |
| Skilled Nursing Facility | 314000000X | 0044065 | IL |
Addresses
Primary practice location
1100 Pembridge Dr
Lake Forest, IL 60045
Mailing address
3200 Grant St
Attn Accounting Department
Evanston, IL 60201
Phone (847) 492-4871
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2100 | Other | BCBS | |
| 4932281 | Other | BCBS |
Other names 1
- Lake Forest Place
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218499200000",
"number": "1831169945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 GRANT ST",
"address_2": "ATTN ACCOUNTING DEPARTMENT",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60201",
"telephone_number": "847-492-4871",
"fax_number": "847-570-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 PEMBRIDGE DR",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "60045",
"telephone_number": "847-604-6700",
"fax_number": "847-604-6604"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESBYTERIAN HOMES",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-23",
"last_updated": "2008-08-12",
"status": "A",
"authorized_official_last_name": "LANDSMAN",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
"authorized_official_telephone_number": "847-492-4859",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "IL",
"license": "0044065",
"primary": true
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "IL",
"license": "0044065",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "0044065",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2100",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4932281",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lake Forest Place",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lake Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.