Defiance SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DEFIANCE SNF, LLC

Doing business as

Illuminate HC Defiance
SKLD Defiance

Practice address

395 Harding St
Defiance, OH 43512-1315

Phone

(312) 590-1055

NPI assigned

Jun 12, 2019

Last updated

Jun 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yair Zuckerman

Title

Ceo

Phone

(312) 590-1055

Specialties & licenses 1

Addresses

Other names 2

• Illuminate HC Defiance Doing business as
• SKLD Defiance Doing business as

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1902465990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAVIS ST STE 200",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014419",
            "telephone_number": "773-620-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 HARDING ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435121315",
            "telephone_number": "312-590-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFIANCE SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "ZUCKERMAN",
        "authorized_official_first_name": "YAIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-590-1055"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illuminate HC Defiance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SKLD Defiance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Defiance Regional Medical Center
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• Defiance Rehabilitation Services
• Defiance SNF Opco LLC (Defiance Health Care Center)
• Defiance Therapeutic Massage & Wellness Center, LLC
• Lisa Demarest, MS, LSW
• Elizabeth Marie Deming, LPN
• Detray Chiropractic Center
• Shaila Renae Dibell, BCBA

• Skilled Nursing Facility in Defiance, OH
• Providers in Defiance, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.