Provider Type Icon

ILLINOIS VETERANS HOME AT LASALLE NPI 1942367453


NPI Information

NPI: 1942367453
Provider Name: ILLINOIS VETERANS HOME AT LASALLE
Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Organization

CLIA Number: 14D1021735

Address:
1015 OCONOR AVE
LA SALLE, IL
ZIP 61301
Phone: (815) 223-0303
Get Directions

ILLINOIS VETERANS HOME AT LASALLE is a residential treatment facility physical disabilities in La Salle, IL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. ILLINOIS VETERANS HOME AT LASALLE NPI is 1942367453. The provider is registered as an organization entity type.

The provider's business location address is:

1015 OCONOR AVE
LA SALLE, IL
ZIP 61301-216
Phone: (815) 223-0303
Fax: (815) 223-5815

The provider's authorized official is John G. Koehler .
The authorized official title is Administrator and has the following contact phone number (815) 223-0303.

The CLIA number assigned to this NPI record is 14D1021735 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 5/24/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2311ZA0620XCustodial Care FacilityAdult Care Home44115ILLINOISNo
3320700000XResidential Treatment Facility, Physical Disabilities44115ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10636590001MEDICARE NSC
2333890MEDICARE PIN
305032039OTHERBCBS
4DC8121MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.