Eldercare, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0023309 Issued in IL

Legal business name

ELDERCARE, INC.

Doing business as

Calvin Johnson Care Center

Practice address

727 North 17TH Street
Belleville, IL 62226-6599

Phone

(618) 234-3323

Fax

(618) 234-9477

NPI assigned

Dec 1, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Steven C. Wolf

Title

President

Phone

(618) 234-2273

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Calvin Johnson Care Center Doing business as

Tax ID family

Calvin Johnson Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eldercare, Inc

  • Skilled Nursing Facility
  • Alton, IL
  • NPI 1285889436
  NPD tax ID

Locations

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1902051154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PARKWAY WEST",
            "address_2": "SUITE 820",
            "city": "BELLESVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-2273",
            "fax_number": "618-234-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 NORTH 17TH STREET",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622266599",
            "telephone_number": "618-234-3323",
            "fax_number": "618-234-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-234-2273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "1400434197",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0023309",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103025508",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA (VETERANS' ADMIN)",
            "identifier": "V255P(657)0911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvin Johnson Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aleisia Eilers, M.A., CCC-SLP
• Douglas Michael Eisele, RPH
• David Jeffrey Eisenstein, MD
• Ameenah S El-Amin, THERAPEUTIC MENTOR
• Eldercare Inc
• Deborah Kay Elimon, MSED.
• Ty Elimon, MSED
• Emily Elster, DMD
• Emergency Services Midwest SC
• Kayla Emerick

• Skilled Nursing Facility in Belleville, IL
• Providers in Belleville, 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 Aug 17, 2018; 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.