Godfrey Healthcare & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1794964 Issued in IL

Legal business name

GODFREY HEALTHCARE & REHABILITATION CENTER LLC

Doing business as

Integrity Healthcare of Godfrey

Practice address

1623 W Delmar Ave
Godfrey, IL 62035-1317

Phone

(618) 466-0443

Fax

(618) 466-1597

NPI assigned

May 24, 2007

Last updated

Feb 28, 2022By 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

Mr. Steven Blisko

Title

Authorized Rep

Phone

(708) 426-2315

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Integrity Healthcare of Godfrey Doing business as

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1962613828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762046",
            "telephone_number": "708-426-2315",
            "fax_number": "708-236-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 W DELMAR AVE",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620351317",
            "telephone_number": "618-466-0443",
            "fax_number": "618-466-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GODFREY HEALTHCARE & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "BLISKO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "AUTHORIZED REP",
        "authorized_official_telephone_number": "708-426-2315",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1794964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205779699",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrity Healthcare of Godfrey",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integrity Healthcare of Godfrey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Elizabeth Gaughan
• Sarah Gieszelmann, FNP
• Alyssa Marie Gilleland, COTA/L
• Aaron Gingrich
• Alexander Giordano, OTR/L
• Godfrey Prescription Shoppe
• Daphne Joanna Gonzalez Aponte, MD
• Stanley Gooding, FNP
• Jennifer Sue Gottlob, COTA/L
• Kara Marie Govreau

• Skilled Nursing Facility in Godfrey, IL
• Providers in Godfrey, 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 Feb 28, 2022; 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.