Eldercare Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0023309 Issued in IL

Legal business name

ELDERCARE INC

Doing business as

Calvin Johnson Care Center

Practice address

727 N 17TH St
Belleville, IL 62226-6552

Phone

(618) 234-3323

Fax

(618) 234-9477

NPI assigned

Nov 15, 2005

Last updated

Apr 20, 2008By 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 C Wolf

Title

President

Phone

(618) 234-2273

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Calvin Johnson Care Center Doing business as

Locations

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1982686093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "SUITE 820",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-2273",
            "fax_number": "618-234-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 17TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622266552",
            "telephone_number": "618-234-3323",
            "fax_number": "618-234-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-234-2273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0023309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA VETERANS ADMIN",
            "identifier": "V255P6570911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvin Johnson Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kate Edgar
• Deborah Kaye Edwards, LPC
• Douglas Michael Eisele, RPH
• David Jeffrey Eisenstein, MD
• Ameenah S El-Amin, THERAPEUTIC MENTOR
• Eldercare, Inc. (Calvin Johnson Care Center)
• Deborah Kay Elimon, MSED.
• Ty Elimon, MSED
• Emily Elster, DMD
• Emergency Services Midwest SC

• Skilled Nursing Facility in Belleville, IL
• Providers in Belleville, 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 20, 2008; 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.