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NONE
NPI 1366639833
Assisted Living Facility in Shabbona, IL

Active since September 28, 2007
407 W COMANCHE AVE, SHABBONA, IL 60550(815) 824-8480(815) 824-2412 Get Directions Write a Review

NPPES record last updated: April 17, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About None NPPES

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

NONE (NPI 1366639833) is a healthcare organization registered as an assisted living facility in Shabbona, Illinois and active in the NPI registry since September 2007. The organization lists Delores J Nicolson, Manager, as its authorized official.

NPPES Registry Identity

NPI1366639833
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSHABBONA SUPPORTIVE LIVING
Location Address407 W COMANCHE AVEShabbona, IL 60550-9501
Mailing Address407 W Comanche AveShabbona, IL 60550-9501 · (815) 824-8480 · Fax (815) 824-2412
Phone(815) 824-8480
Fax(815) 824-2412
Organization SubpartNo
Authorized OfficialDelores J NicolsonManager · (815) 824-8480
Enumeration DateSeptember 28, 2007
Last NPPES UpdateApril 17, 2008
✔ NPI 1366639833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
407 W COMANCHE AVE, Shabbona, IL 60550
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Other Identifiers 1

Medicaid204590974001IL

Other Providers at the Same Location NPPES 2

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

SHABBONA SUPPORTIVE LIVING
Assisted Living Facility
407 W COMANCHE AVE
SHABBONA, IL 60550
Dekalb County (815) 824-8480
PRAIRIE CROSSING ASSISTED LIVING, LLC
Assisted Living Facility
407 W COMANCHE AVE
SHABBONA, IL 60550
Dekalb County (815) 824-8480

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 Shabbona Supportive Living's NPI number?

The NPI number for Shabbona Supportive Living is 1366639833. It was assigned to this organization in the NPPES registry on September 28, 2007.

Where is Shabbona Supportive Living located?

Shabbona Supportive Living is located at 407 W Comanche Ave, Shabbona, IL 60550. The listed phone number is (815) 824-8480.

What is Shabbona Supportive Living's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Shabbona Supportive Living was last updated on April 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.