Healthcare Provider Details

I. General information

NPI: 1114888914
Provider Name (Legal Business Name): FREEPORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 KIWANIS DR
FREEPORT IL
61032-4580
US

IV. Provider business mailing address

900 KIWANIS DR
FREEPORT IL
61032-4580
US

V. Phone/Fax

Practice location:
  • Phone: 815-235-6196
  • Fax:
Mailing address:
  • Phone: 815-235-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AARON LEVY
Title or Position: CEO
Credential:
Phone: 561-676-3719