Villa at South Holland LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0052340 Issued in IL

Legal business name

VILLA AT SOUTH HOLLAND LLC

Practice address

16300 Wausau Ave
South Holland, IL 60473-2158

Phone

(708) 598-5500

Fax

(708) 598-5527

NPI assigned

May 7, 2013

Organization subpart

No

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

Authorized official

Name

Ben Israel

Title

Manager

Phone

(847) 447-2660

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1952746711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 WAUSAU AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732158",
            "telephone_number": "708-598-5500",
            "fax_number": "708-598-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 WAUSAU AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732158",
            "telephone_number": "708-598-5500",
            "fax_number": "708-598-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA AT SOUTH HOLLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-447-2660"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0052340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Ulysse
• United Evangelistic Consulting Association
• Bhupinder K. Valia, M.D.
• Jenae Vaughn
• Helen Misa Vazquez, MD
• Village of South Holland
• Jeffrey L Vollmer, LCPC
• Grace Nwaka Wabomnor, ANP
• Walgreen Co
• Chanel Walker, CMA

• Skilled Nursing Facility in South Holland, IL
• Providers in South Holland, 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 Apr 27, 2021; 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.