Provider Demographics
NPI:1467426676
Name:BUTTERFIELD HEALTH CARE VII, LLC
Entity Type:Organization
Organization Name:BUTTERFIELD HEALTH CARE VII, LLC
Other - Org Name:MEADOWBROOK MANOR OF LAGRANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-472-4500
Mailing Address - Street 1:640 N RIVER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8949
Mailing Address - Country:US
Mailing Address - Phone:331-472-4500
Mailing Address - Fax:331-472-4510
Practice Address - Street 1:339 9TH AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6429
Practice Address - Country:US
Practice Address - Phone:708-354-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0047274314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0047274OtherIDPH FACILITY ID NUMBER
IL=========001Medicaid
IL146093Medicare Oscar/Certification