Active NPI
Alden of Old Town East, Inc.
- Intellectual Disabilities Intermediate Care Facility
- Bloomingdale, IL
National Provider Identifier
1891783627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 0042069
- Legal business name
- ALDEN OF OLD TOWN EAST, INC.
- Practice address
- 108 1St St
Bloomingdale, IL 60108-1220 - Phone
- (630) 671-1703
- Fax
- (630) 671-1706
- NPI assigned
- Oct 6, 2005
- 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
- Floyd A Schlossberg
- Title
- President
- Phone
- (773) 286-6622
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 0042069 | IL | Primary |
Addresses
Primary practice location
108 1St St
Bloomingdale, IL 60108-1220
Mailing address
4200 W Peterson Ave
Suite 140
Chicago, IL 60646-6074
Phone (773) 286-6622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G367
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- ALDEN OF OLD TOWN EAST
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Aug 21, 1998
- Last certification
- Aug 22, 2024
- Beds
- 16
- Ownership / control type
- Private (proprietary)
- Facility address
- 108 South First Street
Bloomingdale, IL 60108
National Provider Directory
National Provider Directory- Tax ID family
- Alden of Old Town East Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Bloomingdale, IL
- NPI 1851756688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1891783627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 W PETERSON AVE",
"address_2": "SUITE 140",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606466074",
"telephone_number": "773-286-6622",
"fax_number": "773-286-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 1ST ST",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601081220",
"telephone_number": "630-671-1703",
"fax_number": "630-671-1706"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALDEN OF OLD TOWN EAST, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SCHLOSSBERG",
"authorized_official_first_name": "FLOYD",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-286-6622"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "IL",
"license": "0042069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.