TRI-STATE NURSING & REHABILITATION CENTER INC (NPI# 1831214154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831214154 |
| Entity Type | Organization |
| Organization Name | TRI-STATE NURSING & REHABILITATION CENTER INC |
| Practice Address |
2500 175th St Lansing IL 60438-1801 |
| Practice Telephone | 7084747330 |
| Practice Fax Number | 7084747391 |
| Mailing Telephone | 7084747330 |
| Mailing Fax Number | 7084747391 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-12-11 |
| Authorized Official Name | MARK STEINBERG (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 8479053000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | 0041186 | IL | Nursing & Custodial Care Facilities |
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0041186 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 1230 | 01 |
| Street Address |
2500 175TH ST |
| City | LANSING |
| State | IL |
| Zip Code | 60438-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962974584 | Tiffany Dunlap | Occupational Therapy Assistant | 2500 175th St, Lansing, IL 60438-1801 | 2018-12-20 |
| 1861963217 | Tri-state Village Nursing and Rehabilitation Center LLC | Skilled Nursing Facility | 2500 175th St, Lansing, IL 60438-1801 | 2018-12-11 |
| 1053834804 | Ashley Marie Johnson | Nurse Practitioner | 2500 175th St, Lansing, IL 60438-1801 | 2017-07-24 |
| 1790108082 | Emily Fosnaugh | Physical Therapy Assistant | 2500 175th St, Lansing, IL 60438-1801 | 2014-01-23 |
| 1689097800 | Nicholas Mortier | Speech-Language Pathologist | 2500 175th St, Lansing, IL 60438-1801 | 2014-01-23 |
| 1093144545 | Jocelin Nicole Mendez | Technician, Other | 2500 175th St, Lansing, IL 60438-1801 | 2013-11-05 |
| 1447500699 | Senthil Kumar Kanagasabapathy | Physical Therapist | 2500 175th St, Lansing, IL 60438-1801 | 2012-09-14 |
| 1710236476 | Hector Navarro | Physical Therapy Assistant | 2500 175th St, Lansing, IL 60438-1801 | 2012-09-09 |
| 1003162991 | Rhiannon Amber Duran | Speech-Language Pathologist | 2500 175th St, Lansing, IL 60438-1801 | 2012-07-27 |
| 1336415702 | Yarif Vhora | Occupational Therapy Assistant | 2500 175th St, Lansing, IL 60438-1801 | 2012-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013429984 | Gentle Touch Healthcare Services | In Home Supportive Care | 18236 Ridgewood, Lansing, IL 60438 | 2017-10-31 |
| 1336658699 | Elizabeth M Cichocki | Speech-Language Pathologist | Memorial Jr. High School, 2721 Ridge Rd., Lansing, IL 60438 | 2017-09-29 |
| 1023527595 | Sue Hecht | Speech-Language Pathologist | 18300 Greenbay, Lansing, IL 60438 | 2017-09-27 |
| 1275960130 | Senegal Enterprises Medical, Inc | Durable Medical Equipment & Medical Supplies | 3330 181st Place, Suite 103, Lansing, IL 60438 | 2013-10-08 |
| 1295062404 | Dominion Home Health Care Inc. | Home Health | 2521 Ridge Road, Suite 4, Lansing, IL 60438 | 2009-11-09 |
| 1013076348 | Wayne M Mrjenovich Dds PC | Dentist | 19111 Burnham Ave, Lansing, IL 60438 | 2006-12-06 |
| 1124198247 | Jennifer Meyer | Counselor | 17041 Chicago Ave, Lansing, IL 60438 | 2006-11-08 |
| 1821171182 | Nurse Coordinators & Home Health | Home Health | 1955 Bernice Rd, Suite 1sw, Lansing, IL 60438 | 2006-10-23 |
| 1275633133 | Hoovers Home Health Inc | Durable Medical Equipment & Medical Supplies | 3326 Ridge Rd, Lansing, IL 60438 | 2006-09-22 |
| 1942307053 | Brant T Molenaar | Optometrist | 3546 Ridge Road, Lansing, IL 60438 | 2006-09-20 |
| Find all providers in zip 60438 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386094068 | Icg Home Health | Nursing Facility/Intermediate Care Facility | 4508 Camden Ct, Richton Park, IL 60471-1147 | 2016-06-14 |
| 1871999078 | Midwest Health Operations LLC | Nursing Facility/Intermediate Care Facility | 3601 16th Ave, Sterling, IL 61081-4059 | 2014-11-15 |
| 1437410891 | Mado Healthcare | Nursing Facility/Intermediate Care Facility | 1541 North Wells, Chicago, IL 60610-1307 | 2012-06-01 |
| 1134405392 | Faith Community Health Services, Inc | Nursing Facility/Intermediate Care Facility | 4449 177th St, Country Club Hills, IL 60478-4705 | 2011-11-01 |
| 1215188487 | Petersen Health Care, Inc | Nursing Facility/Intermediate Care Facility | 144 Jounior Ave., Kewanee, IL 61443 | 2008-10-07 |
| 1699936054 | Pinckneyville Healthcare Center | Nursing Facility/Intermediate Care Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-06-18 |
| 1184894412 | Parents and Friends of The Slc-home 1 | Nursing Facility/Intermediate Care Facility | 3 Gundlach Pl, Swansea, IL 62226-4227 | 2008-03-03 |
| 1740463074 | St. Joseph's Home of Springfield | Nursing Facility/Intermediate Care Facility | 3306 S 6th Street Rd, Springfield, IL 62703-4735 | 2007-12-10 |
| 1821283573 | Royal Living Center Inc | Nursing Facility/Intermediate Care Facility | 200 South 9th Street, New Baden, IL 62265 | 2007-09-06 |
| 1235323841 | Parents and Friends of Slc | Nursing Facility/Intermediate Care Facility | 1450 Caseyville Ave, Swansea, IL 62226-4517 | 2007-08-28 |
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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.