NPIMap

Organization Active NPI

Marianjoy at Providence Downer Grove

  • Skilled Nursing Facility
  • Downers Grove, IL
National Provider Identifier
1831332402
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARIANJOY AT PROVIDENCE DOWNER GROVE
Practice address
3450 Saratoga Ave
Downers Grove, IL 60515-1141
Phone
(630) 909-7370
Fax
(630) 909-7371
NPI assigned
Apr 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Authorized official

Name
Mrs. Jacquelyn Barnes
Title
PFS Manager
Phone
(630) 909-7378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3450 Saratoga Ave
Downers Grove, IL 60515-1141

Mailing address

27 W 171 Roosevelt Road
Wheaton, IL 60187-1141
Phone (630) 909-7378

Other identifiers 1

IdentifierTypeStateIssuer
50425OtherILBLUE CROSS BLUE SHIELD ILLINOIS

National Provider Directory

National Provider Directory
Tax ID family
Marianjoy Rehab Hosp NE5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1831332402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 W 171 ROOSEVELT ROAD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601871141",
            "telephone_number": "630-909-7378",
            "fax_number": "630-909-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 SARATOGA AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151141",
            "telephone_number": "630-909-7370",
            "fax_number": "630-909-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANJOY AT PROVIDENCE DOWNER GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "PFS MANAGER",
        "authorized_official_telephone_number": "630-909-7378",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ILLINOIS",
            "identifier": "50425",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.