MARIANJOY AT PROVIDENCE VICTORIAN VILLAGE
NPI 1174912562
Skilled Nursing Facility in Homer Glen, IL

Active since January 22, 2015
12525 RENAISSANCE CIR, HOMER GLEN, IL 60491(708) 590-5050 Get Directions Write a Review

NPPES record last updated: January 22, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Marianjoy At Providence Victorian Village NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIANJOY AT PROVIDENCE VICTORIAN VILLAGE (NPI 1174912562) is a healthcare organization registered as a skilled nursing facility in Homer Glen, Illinois and active in the NPI registry since January 2015. The organization lists Laura J. Booker, Pfs Contracted Lead, as its authorized official.

NPPES Registry Identity

NPI1174912562
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMARIANJOY AT PROVIDENCE VICTORIAN VILLAGE
Location Address12525 RENAISSANCE CIRHomer Glen, IL 60491-5896
Mailing Address12525 Renaissance CirHomer Glen, IL 60491-5896 · (708) 590-5050
Organization SubpartNo
Authorized OfficialLaura J. BookerPfs Contracted Lead · (630) 909-7374
Enumeration DateJanuary 22, 2015
NPI 1174912562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
12525 RENAISSANCE CIR, Homer Glen, IL 60491

Other Identifiers 1

Medicare UPIN143027

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
12525 RENAISSANCE CIR
HOMER GLEN, IL 60491
Nursing Home Administrator
12525 RENAISSANCE CIR
HOMER GLEN, IL 60491
Skilled Nursing Facility
12525 RENAISSANCE CIR
HOMER GLEN, IL 60491

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marianjoy At Providence Victorian Village's NPI number?

The NPI number for Marianjoy At Providence Victorian Village is 1174912562. It was assigned to this organization in the NPPES registry on January 22, 2015.

Where is Marianjoy At Providence Victorian Village located?

Marianjoy At Providence Victorian Village is located at 12525 Renaissance Cir, Homer Glen, IL 60491. The listed phone number is (708) 590-5050.

What is Marianjoy At Providence Victorian Village's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Marianjoy At Providence Victorian Village was last updated on January 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.