CALUMET CITY TERRACE
NPI 1215100896
Intermediate Care Facility, Intellectual Disabilities in Calumet City, IL

NPI Status: Active since April 04, 2008

Contact Information

1380 RIVER DRIVE
CALUMET CITY, IL
ZIP 60409
Phone: (708) 730-3312
Fax: (708) 730-1584

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  • Organization
  • Intermediate Care Facility, Intellectual...
  • CLIA Number: 14D2272112
  • CLIA Cert. Type: School/Student Health Service
  • CLIA Exp. Date: 11-14-2026

About CALUMET CITY TERRACE

This page provides the complete NPI Profile along with additional information for Calumet City Terrace, a provider established in Calumet City, Illinois operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1215100896 assigned on April 2008. The practitioner's primary taxonomy code is 315P00000X with license number 43190 (IL). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Calumet City Terrace. The authorized official of this NPI record is Mr. Ronald J Wilson (Authorized Agent)

NPI
1215100896
Provider Legal Name
PIONEER CONCEPTS INC
Other Organization Name
CALUMET CITY TERRACE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1380 RIVER DRIVE CALUMET CITY, IL 60409
Location Phone
(708) 730-3312
Location Fax
(708) 730-1584
Mailing Address
285 SOUTH FARNHAM STREET GALESBURG, IL 61401
Mailing Phone
(309) 343-1550
Mailing Fax
(708) 730-1584
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
04-04-2008
Last Update Date
04-20-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
License No.
43190
License State
IL
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RONALD J WILSON

Authorized Official Title
AUTHORIZED AGENT
Authorized Official Phone
(309) 343-1550

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========002MEDICAID (05)IL 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2272112
Facility Type
School/Student Health Service
Certificate Effective Date
November 15, 2024
Certificate Expiration Date
November 14, 2026
Laboratory Director
JOSEPH H. ZOTTO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Calumet City Terrace to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215100896, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
0
Doubled → 0
Pos 8
8
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 2 + 0 + 0 + 8 + 1 + 8 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1215100896.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215100896, enumerated as an "organization" on April 04, 2008.

The provider is located at 1380 RIVER DRIVE CALUMET CITY, IL 60409 and the phone number is (708) 730-3312.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.