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ILLINOIS VETERANS HOME AT MANTENO
NPI 1831248228
Residential Treatment Facility, Physical Disabilities in Manteno, IL

Active since January 09, 2007CLIA 14D1011391 · Waiver
1 VETERANS DR, MANTENO, IL 60950(815) 468-6581(815) 468-7001 Get Directions Write a Review

NPPES record last updated: July 15, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Illinois Veterans Home At Manteno NPPES

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

ILLINOIS VETERANS HOME AT MANTENO (NPI 1831248228) is a healthcare organization registered as a residential treatment facility, physical disabilities in Manteno, Illinois and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through April 8, 2027 and lists Reginald L Booker, Administrator, as its authorized official.

NPPES Registry Identity

NPI1831248228
Entity TypeOrganization
Primary Taxonomy320700000X
Legal Business NameILLINOIS VETERANS HOME AT MANTENO
Location Address1 VETERANS DRManteno, IL 60950-9466
Mailing Address1 Veterans Dr, Bldg A-2mManteno, IL 60950-9466 · (217) 222-9487 · Fax (217) 222-8578
Phone(815) 468-6581
Fax(815) 468-7001
Organization SubpartNo
Authorized OfficialReginald L BookerAdministrator · (815) 468-6581
Enumeration DateJanuary 9, 2007
Last NPPES UpdateJuly 15, 2010
✔ NPI 1831248228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyResidential Treatment Facility, Physical DisabilitiesResidential Treatment Facilities
Taxonomy Code320700000X
License✔ Licensed in IL · 0042218
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
Also ListedCustodial Care Facility · Adult Care HomeTaxonomy 311ZA0620X · License 0042218 (IL)
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1 VETERANS DR, Manteno, IL 60950
Open in Google Maps ↗

Other Identifiers 4

Medicare PINCI2630
Medicare PIN226040
Other04621430Bcbs
Medicare NSC0650890001

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Illinois Veterans Home At Manteno is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Illinois Veterans Home At Manteno, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Maung Win, MD
Internal Medicine
NPI 1639236599
NO 1 VETERANS DR
Manteno, IL 60950
(815) 468-6581
✔ PECOS0.2 mi
Michelle Riggins, FNP
Nurse Practitioner
NPI 1407392491
92 FIR ST
Park Forest, IL 60466
(708) 543-6384
✔ PECOS19 mi
Subhash Waikar, MD
Internal Medicine
NPI 1154347045
333 DIXIE HWY
Chicago Heights, IL 60411
(708) 756-1000
✔ PECOS22 mi
Kimberly Grzesik, MS, RN, AGACNP-BC
Nurse Practitioner
NPI 1407381296
16450 S 97TH AVE
Orland Park, IL 60467
(708) 403-6500
✔ PECOS25 mi
John Gietzen, D.O.
Family Practice
NPI 1538178025
W5491 WINDMILL RIDGE RD
New Glarus, WI 53574
(608) 518-3654
✔ PECOS✔ Accepts Medicare145 mi
John Girardi, MD
Emergency Medicine
NPI 1346248143
2 S HOSPITAL DR
Murphysboro, IL 62966
(618) 684-3156
✔ PECOS✔ Accepts Medicare252 mi
Lasheah Stewart, NP
Nurse Practitioner
NPI 1114318136
1900 MATLOCK RD STE 804
Mansfield, TX 76063
(682) 800-3211
✔ PECOS787 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1011391

Illinois Veterans Home At Manteno · Manteno, IL
Active · expires Apr 8, 2027
CLIA Number14D1011391
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 9, 2025
Certificate Expiration DateApril 8, 2027
Laboratory DirectorTanya Huston Smith
Laboratory Phone(815) 468-6581
Laboratory LocationIllinois Veterans Home At MantenoOne Veterans Drive, Manteno, IL 60950
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Illinois Veterans Home At Manteno's NPI number?

The NPI number for Illinois Veterans Home At Manteno is 1831248228. It was assigned to this organization in the NPPES registry on January 9, 2007.

Where is Illinois Veterans Home At Manteno located?

Illinois Veterans Home At Manteno is located at 1 Veterans Dr, Manteno, IL 60950. The listed phone number is (815) 468-6581.

What is Illinois Veterans Home At Manteno's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Physical Disabilities with taxonomy code 320700000X.

Is Illinois Veterans Home At Manteno enrolled in Medicare?

Yes. Illinois Veterans Home At Manteno is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Illinois Veterans Home At Manteno?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 4 Medicare specialties reassign their Medicare billing to Illinois Veterans Home At Manteno. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Internal Medicine (2) and Emergency Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Illinois Veterans Home At Manteno hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1011391) is associated with this NPI, valid through April 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Illinois Veterans Home At Manteno was last updated on July 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.