GAF/LAKE COOK TERRACE (NPI# 1659368264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659368264 |
| Entity Type | Organization |
| Organization Name | GAF/LAKE COOK TERRACE |
| Other Organization Name | LAKE COOK HEALTH CENTER |
| Practice Address |
263 Skokie Blvd Northbrook IL 60062-1611 |
| Practice Telephone | 8475640505 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MELODY GOODMAN (MDS COORDINATOR) |
| Authorized Official Telephone | 8475640505 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 3639624779001 | 05 |
| Other Name | Type Code |
|---|---|
| LAKE COOK HEALTH CENTER | Doing Business As Name - Organization |
| Street Address |
263 SKOKIE BLVD |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-1611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184272544 | Melanie Niepsuj | Social Worker | 263 Skokie Blvd, Northbrook, IL 60062-1611 | 2019-08-29 |
| 1871965186 | Northbrook Skilled Nursing Facility LLC | Skilled Nursing Facility | 263 Skokie Blvd, Northbrook, IL 60062-1611 | 2015-10-26 |
| 1659624112 | Grove of Northbrook Living & Rehab Center LLC | Skilled Nursing Facility | 263 Skokie Blvd, Northbrook, IL 60062-1611 | 2012-10-22 |
| 1942344007 | Lake Cook Terrace Nursing Center | Skilled Nursing Facility | 263 Skokie Blvd, Northbrook, IL 60062-1611 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831405695 | Favor In The Land | Custodial Care Facility | 150 N Mason Ave, 1suite, Chicago, IL 60644-2801 | 2010-08-30 |
| 1598947418 | Ingalls Home Care | Custodial Care Facility | 19730 Governors Hwy, Flossmoor, IL 60422-2082 | 2007-12-03 |
| 1841479797 | Villa Health Care Inc | Custodial Care Facility | 100 Stardust Dr, Sherman, IL 62684-9763 | 2007-10-29 |
| 1831275999 | Eastgate Manor of Algonquin LLC | Custodial Care Facility | 101 Eastgate Court, Algonquin, IL 60102 | 2006-10-31 |
| 1396840153 | Good Samaritan Home of Quincy | Custodial Care Facility | 2130 Harrison St, Quincy, IL 62301-6756 | 2006-09-14 |
| 1780660878 | The Pointe At Kilpatrick | Custodial Care Facility | 14230 Kilpatrick Ave, Crestwood, IL 60445-2399 | 2005-12-20 |
| 1558343301 | St. Marys Health Care Center Investors LLC | Custodial Care Facility | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2005-11-17 |
| 1457705774 | J and F Professional In Home Care Services for Seniors | Custodial Care Facility | 328 Sherry Ln, Chicago Heights, IL 60411-1079 | 2016-04-22 |
| 1760804967 | Treaad Incorporated | Custodial Care Facility | 600 Borden St, Woodstock, IL 60098-2137 | 2014-01-08 |
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on GAF/LAKE COOK TERRACE.
| 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.