Illinois Veterans Home at Chicago

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

ILLINOIS VETERANS HOME AT CHICAGO

Practice address

4250 N Oak Park Ave
Chicago, IL 60634-1417

Phone

(773) 794-3763

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

T'Kira Siler-Wilkerson

Title

Administrator

Phone

(773) 628-5905

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Mehul R Shah, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1538196043
  Medicare reassignment NPD

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1891367330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341417",
            "telephone_number": "773-794-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS VETERANS HOME AT CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "SILER-WILKERSON",
        "authorized_official_first_name": "T'KIRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-628-5905"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illinois Skin Center LLC
• Illinois Spine and Joint Center LTD.
• Illinois Surgeon Association LLC
• Illinois Therapeutic and Nursing Services, LLC
• Illinois Therapeutic Services, LLC
• Illinois Visiting Doctors
• Illinois Wellness and Weight Loss Centers SC
• Illinois/Indiana Em-I Medical Services, S.C.
• Illinois/Indiana Em-I Medical Services, S.C.
• Illumental Counseling and Psychiatry, PLLC

• Physical Disabilities Residential Treatment Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Disabilities Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.