NPIMap

Organization Active NPI

Grand Victorian of Sycamore

  • Assisted Living Facility
  • Sycamore, IL
National Provider Identifier
1972264349
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GRAND VICTORIAN OF SYCAMORE
Practice address
1440 Somonauk St
Sycamore, IL 60178-2916
Phone
(815) 895-1900
Fax
(815) 739-2253
NPI assigned
Jan 6, 2022
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WELL PATH TENANT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Jerome Finis
Title
Manager
Phone
(847) 274-9596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1440 Somonauk St
Sycamore, IL 60178-2916

Mailing address

200 E Court St Ste 400
Kankakee, IL 60901-3848
Phone (815) 935-1992

Other identifiers 1

IdentifierTypeStateIssuer
5107948OtherILIDPH ASSISTED LIVING LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Brookstone Estates of Rantoul19 organizations share this tax ID, including this one
Part of
Brookstone Estates of Rantoul

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

222 S Riverside Plz
Fl 20
Chicago, IL 60606

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1972264349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E COURT ST STE 400",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013848",
            "telephone_number": "815-935-1992",
            "fax_number": "815-935-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 SOMONAUK ST",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782916",
            "telephone_number": "815-895-1900",
            "fax_number": "815-739-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VICTORIAN OF SYCAMORE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELL PATH TENANT, LLC",
        "enumeration_date": "2022-01-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "FINIS",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-274-9596"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH ASSISTED LIVING LICENSE",
            "identifier": "5107948",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.