Carbondale Rehabilitation and Nursing Center II LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0046920 Issued in IL

Legal business name

CARBONDALE REHABILITATION AND NURSING CENTER II LLC

Practice address

500 S Lewis LN
Carbondale, IL 62901-3448

Phone

(618) 529-5355

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Steven Blisko

Title

Member

Phone

(708) 236-0000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1942207832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "708-236-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S LEWIS LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013448",
            "telephone_number": "618-529-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBONDALE REHABILITATION AND NURSING CENTER II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "BLISKO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "708-236-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE NUMBER",
            "identifier": "0046920",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bergandi Rose Carley, RPH
• Donna P Carney, M.D.

• Skilled Nursing Facility in Carbondale, IL
• Providers in Carbondale, 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 Jan 27, 2015; 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.