Provider Demographics
NPI:1346413879
Name:ZACRE,LLC
Entity Type:Organization
Organization Name:ZACRE,LLC
Other - Org Name:FRANCISCAN COURT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:CAULKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-562-4242
Mailing Address - Street 1:1996 FRANCISCAN WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-6232
Mailing Address - Country:US
Mailing Address - Phone:630-562-4242
Mailing Address - Fax:630-562-3593
Practice Address - Street 1:1996 FRANCISCAN WAY
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-6232
Practice Address - Country:US
Practice Address - Phone:630-562-4242
Practice Address - Fax:630-562-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid