CLARK-LINDSEY VILLAGE INC. (NPI# 1033565882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033565882 |
Entity Type | Organization |
Organization Name | CLARK-LINDSEY VILLAGE INC. |
Practice Address |
101 W Windsor Rd Urbana IL 61802-6663 |
Practice Telephone | 2173442144 |
Practice Fax Number | 2173449147 |
Mailing Telephone | 2173442144 |
Mailing Fax Number | 2173449147 |
Enumeration Date | 2016-05-11 |
Last Update Date | 2017-04-24 |
Authorized Official Name | DEBRA REARDANZ (CEO/PRESIDENT) |
Authorized Official Telephone | 2173442144 |
Authorized Official Credential | ADMINISTRATOR |
Is Organization Subpart | Y |
Parent Organization Name | CLARK-LINDSEY VILLAGE INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
Street Address |
101 W WINDSOR RD |
City | URBANA |
State | IL |
Zip Code | 61802-6663 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922003326 | Clark-lindsey Village, Inc. | Skilled Nursing Facility | 101 W Windsor Rd, Urbana, IL 61802-6663 | 2005-06-14 |
1457889636 | Victoria Ting | Speech-Language Pathologist | 101 W Windsor Rd, Urbana, IL 61802-6663 | 2017-05-31 |
1588904692 | Elizabeth Anne Peterson | Speech-Language Pathologist | 101 W Windsor Rd, Urbana, IL 61802-6663 | 2013-02-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932756186 | Guadalupe Guzman | Technician | 3205 E Airport Rd, Urbana, IL 61802 | 2019-08-22 |
1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
1447769591 | Joe Mata | Non-emergency Medical Transport (VAN) | 606 Oakland Ave Apt 212, Urbana, IL 61802 | 2017-09-20 |
1326423153 | Allison Donald | Occupational Therapy Assistant | 500 Bartell Rd., Urbana, IL 61802 | 2015-07-22 |
1083013874 | Erin E Gianaras | Pharmacist | 2500 S Philo Rd, Urbana, IL 61802 | 2014-08-18 |
1881962744 | Nataly Briceno Guerrero | Occupational Therapist | 805 S Sunny Lane, Urbana, IL 61802 | 2011-12-07 |
1184917643 | Melody Meyer | Physical Therapy Assistant | 1704 E Amber Glenn Road, Urbana, IL 61802 | 2011-05-17 |
1265736110 | Blueprint | Social Worker | 2704 Boulder Drive, Suite B, Urbana, IL 61802 | 2011-01-07 |
1497989040 | Jennifer Renee Davis | Rehabilitation Counselor | 1513 County Rd 2300 North, Urbana, IL 61802 | 2009-05-12 |
1356543060 | Shan Brown | Nurse Practitioner | 2158 C.r. 1900 E., Urbana, IL 61802 | 2007-06-04 |
Find all providers in zip 61802 |
Taxonomy Code | 261QR0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation |
Definition to come... |
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1285248351 | Rci (wrs), LLC. | Clinic/Center | 884 S Rand Rd Ste A, Lake Zurich, IL 60047-3412 | 2020-09-04 |
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1043824287 | Rci (wrs), LLC. | Clinic/Center | 1525 E 55th St Ste 305, Chicago, IL 60615-5576 | 2020-09-04 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.