JERSEYVILLE ESTATES NPI 1336428937

NPI Information

  • NPI: 1336428937
  • Provider Name: JERSEYVILLE ESTATES
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 14D0869007
  • Address: 1210 E FAIRGROUND AVE
    JERSEYVILLE, IL
    ZIP 62052
  • Phone: (618) 639-9700

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NPI Details

JERSEYVILLE ESTATES is an assisted living facility in Jerseyville, IL. The provider is 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. JERSEYVILLE ESTATES NPI is 1336428937. The provider is registered as an organization entity type.

The provider's business location address is:

1210 E FAIRGROUND AVE
JERSEYVILLE, IL
ZIP 62052-153
Phone: (618) 639-9700
Fax: (618) 639-9701

The provider's authorized official is James Michael Greer .
The authorized official title is Managing General Partner and has the following contact phone number (618) 639-9700.

The CLIA number assigned to this NPI record is 14D0869007 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2011 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility0001ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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