VERONICA MACK (NPI# 1194271825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194271825 |
| Entity Type | Organization |
| Organization Name | VERONICA MACK |
| Practice Address |
9738 S Merrion Ave Chicago IL 60617-4846 |
| Mailing Address |
9738 S Merrion Chicago IL 60617 |
| Practice Telephone | 7736733960 |
| Mailing Telephone | 7736733960 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | VERONICA MACK (CNA) |
| Authorized Official Telephone | 7736733960 |
| Authorized Official Credential | #0792-1021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 07921021 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CNA | 07921021 | 01 |
| Street Address |
9738 S MERRION AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053812974 | Alden Estates-courts of Huntley, Inc. | Skilled Nursing Facility | 4200 W Peterson Ave Ste 140, Chicago, IL 60646-6819 | 2018-02-26 |
| 1982050886 | Bernadette Aguilar | Skilled Nursing Facility | 125 S Green St, Unit 808a, Chicago, IL 60607-3197 | 2016-05-10 |
| 1720445539 | Maria Callahan | Skilled Nursing Facility | 1839 S Prairie Pkwy, Chicago, IL 60616-4389 | 2016-01-25 |
| 1265856710 | Royal Staff Inc | Skilled Nursing Facility | 10934 S Beverly Ave, Chicago, IL 60643-3752 | 2014-02-04 |
| 1114355336 | Mobile Anesthesiologist | Skilled Nursing Facility | 8420 Bryn Mawr, Chicago, IL 60631 | 2013-10-25 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1982946604 | Admiral At The Lake | Skilled Nursing Facility | 933 W. Foster Ave, Chicago, IL 60640 | 2013-03-20 |
| 1730447566 | Sound Imaging Inc. | Skilled Nursing Facility | 6970 N Mcalpin Ave, Chicago, IL 60646-1141 | 2012-04-30 |
| 1821355561 | Ltc Practitioners of Illinois | Skilled Nursing Facility | 3915 N. Kenneth Ave., Chicago, IL 60641-2816 | 2012-04-19 |
| 1558642314 | Lakeview Rehabilitation and Nursing Center | Skilled Nursing Facility | 735 W Diversey Pkwy, Chicago, IL 60614-2337 | 2011-09-06 |
| Find all providers in CHICAGO | ||||
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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.