WOODRIDGE OF PONITAC LLC (NPI# 1871739185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871739185 |
| Entity Type | Organization |
| Organization Name | WOODRIDGE OF PONITAC LLC |
| Practice Address |
120 North Deerfield Road Pontiac IL 61764 |
| Practice Telephone | 8158442100 |
| Practice Fax Number | 8158442103 |
| Mailing Telephone | 8158442100 |
| Mailing Fax Number | 8158442103 |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2008-12-17 |
| Authorized Official Name | MARSHALL A MAUER (MANAGER) |
| Authorized Official Telephone | 8158442100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
120 NORTH DEERFIELD ROAD |
| City | PONTIAC |
| State | IL |
| Zip Code | 61764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1407287121 | Institute for Human Resources of Livingston County, Il | Community/Behavioral Health | 301 E Torrance Ave, Pontiac, IL 61764 | 2013-12-05 |
| 1982031241 | Annette G Franzen | Psychologist | 700 W Lincoln St # 406, Pontiac, IL 61764 | 2013-10-02 |
| 1861601171 | William Earl Hammond | Chiropractor | 210b Ladd, Pontiac, IL 61764 | 2007-05-22 |
| 1932259983 | Amy Duffy | Counselor | 210 W Water St Ste 1, Pontiac, IL 61764 | 2007-01-11 |
| 1326123340 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1034 W. Reynolds Street, Pontiac, IL 61764 | 2006-10-26 |
| 1205932977 | Gary Merl Leverton | Dentist | 518 West Madison St, Pontiac, IL 61764 | 2006-09-16 |
| 1891899886 | Robert E Heins | Family Medicine | 520 West Madison, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1033140199 | Kmart Stores of Illinois LLC | Pharmacy | Vermillion Plaza, Pontiac, IL 61764 | 2006-07-06 |
| Find all providers in zip 61764 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275076028 | Pontiac Supportive Living, LLC | Assisted Living Facility | 120 N Deerfield Rd, Pontiac, IL 61764-9403 | 2016-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1861008872 | Franciscan Communities, Inc. | Assisted Living Facility | 15624 Marian Dr, Homer Glen, IL 60491-6271 | 2020-09-16 |
| 1447865118 | Oakley Courts Assisted Living Community | Assisted Living Facility | 3117 W Kunkle Blvd, Freeport, IL 61032-6943 | 2020-09-10 |
| 1083233076 | Marley Oaks Assisted Living Residence | Assisted Living Facility | 12631 187th St, Mokena, IL 60448-8731 | 2020-04-10 |
| 1447884630 | Cedarhurst of Quincy Operator, LLC | Assisted Living Facility | 319 S 48th St, Quincy, IL 62305-0593 | 2020-02-26 |
| 1164055323 | Cye Sullivan Hco, LLC | Assisted Living Facility | 20 Courtyard Blvd, Sullivan, IL 61951-7001 | 2020-02-17 |
| 1255964573 | Cottages At Salem, Inc. | Assisted Living Facility | 339 S Hotze Rd, Salem, IL 62881-6858 | 2020-02-14 |
| 1841821014 | Generations At Oakton Arms, LLC | Assisted Living Facility | 1665 Oakton Pl, Des Plaines, IL 60018-6301 | 2020-01-28 |
| 1710521984 | Cottages At Carlinville, Inc | Assisted Living Facility | 18804 Rt. 4, Carlinville, IL 62626 | 2019-10-31 |
| 1275184889 | The Encore At The Twin Cities | Assisted Living Facility | 101 N Wacker Dr Ste 608, Chicago, IL 60606-1726 | 2019-09-25 |
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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.