LIBERTYVILLE MANOR (NPI# 1841424900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841424900 |
| Entity Type | Organization |
| Organization Name | LIBERTYVILLE MANOR |
| Practice Address |
610 Peterson Rd Libertyville IL 60048-1014 |
| Mailing Address |
1007 Jenkisson Ave Lake Bluff IL 60044-1623 |
| Practice Telephone | 8473676100 |
| Mailing Telephone | 8472349467 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |
| Authorized Official Name | MR. MILAN STOKAVICH (ADMINISTRATOR) |
| Authorized Official Telephone | 8473676100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 160000723 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | TAXONOMY | 225200000 | 01 |
| Street Address |
610 PETERSON RD |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952390585 | Libertyville Manor Extended Care Facility, Inc. | Skilled Nursing Facility | 610 Peterson Rd, (highway #137), Libertyville, IL 60048-1014 | 2005-10-17 |
| 1265670913 | Anna Pamela Canlas | Physical Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2009-02-02 |
| 1508004334 | Joan Louise Kosman | Physical Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2009-02-02 |
| 1659519437 | Eileen Ann Roehrich | Occupational Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2009-02-01 |
| 1841438777 | Portia Tinker | Physical Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2009-01-30 |
| 1134367121 | Susan Uilani Versino | Physical Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2009-01-28 |
| 1700044534 | Betty Ann Saunders | Occupational Therapist | 610 Peterson Rd, Libertyville, IL 60048-1014 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| 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 |
|---|---|---|---|---|
| 1952390585 | Libertyville Manor Extended Care Facility, Inc. | Skilled Nursing Facility | 610 Peterson Rd, (highway #137), Libertyville, IL 60048-1014 | 2005-10-17 |
| 1316948912 | County of Lake | Skilled Nursing Facility | 1125 N Milwaukee Ave, Libertyville, IL 60048-1304 | 2005-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| Find all providers with the same taxonomy | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
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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.