Provider Demographics
NPI:1588638795
Name:BUTTERFIELD HEALTH CARE II, INC.
Entity Type:Organization
Organization Name:BUTTERFIELD HEALTH CARE II, INC.
Other - Org Name:MEADOWBROOK MANOR OF NAPERVILLE
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:630-759-1112
Mailing Address - Street 1:431 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4918
Mailing Address - Country:US
Mailing Address - Phone:630-759-1112
Mailing Address - Fax:
Practice Address - Street 1:720 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9758
Practice Address - Country:US
Practice Address - Phone:630-355-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0041285314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0041285OtherIDPH FACILITY ID NUMBER
IL0041285OtherIDPH FACILITY ID NUMBER
145874Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER