MEDICARE: IGNITE HUNTERSVILLE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1316897572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IGNITE HUNTERSVILLE LLC

Provider Business Mailing Address
First Line	:	1550 N NORTHWEST HWY STE 430
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1461
Country	:	US
Telephone Number	:	847-453-4000
Fax Number	:	847-453-4000

Provider Business Practice Location Address
First Line	:	12019 VERHOEFF DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-9217
Country	:	US
Telephone Number	:	847-453-4000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIMOTHY FIELDS
Credential	:
Telephone Number	:	847-453-4000

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “IGNITE HUNTERSVILLE LLC ” Practice Location

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