Active NPI
Zachary House
- Intellectual Disabilities Intermediate Care Facility
- Streamwood, IL
National Provider Identifier
1952596165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- ZACHARY HOUSE
- Practice address
- 1102 East Avenue
Streamwood, IL 60107 - Phone
- (630) 483-0537
- Fax
- (630) 483-0537
- NPI assigned
- Sep 11, 2007
- Last updated
- Sep 11, 2007
- 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
- Robin Witt
- Title
- Chief Financial Officer
- Phone
- (847) 397-0055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | NU | Primary |
Addresses
Primary practice location
1102 East Avenue
Streamwood, IL 60107
Mailing address
1102 East Avenue
Streamwood, IL 60107
Phone (630) 483-0537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1952596165. Details of each certification follow.
Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G363
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
- ZACHARY HOUSE
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Feb 26, 1997
- Last certification
- Aug 1, 2024
- Beds
- 16
- Ownership / control type
- Private (proprietary)
- Facility address
- 1102 East Avenue
Streamwood, IL 60107
National Provider Directory
National Provider DirectoryLocations
1102 East Ave
Streamwood, IL 60107
Phone (630) 483-0537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1189468800000",
"number": "1952596165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 EAST AVENUE",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "60107",
"telephone_number": "630-483-0537",
"fax_number": "630-483-0537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 EAST AVENUE",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "60107",
"telephone_number": "630-483-0537",
"fax_number": "630-483-0537"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ZACHARY HOUSE",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A",
"authorized_official_last_name": "WITT",
"authorized_official_first_name": "ROBIN",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "847-397-0055"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streamwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.