Estates Of Hyde Park LLC
Skilled Nursing Facility in Chicago, IL. Organization (NPI-2).
NPI number1669887394
StatusActive
Last updated in NPPESSep 30, 2015
Details
- NPI
- 1669887394
- Entity type
- Organization (NPI-2)
- Legal business name
- Estates Of Hyde Park LLC
- Organization subpart
- No
- Enumeration date
- Jun 20, 2014
- Last updated
- Sep 30, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Practice location
4505 S Drexel BlvdChicago, IL 60653-4301
Phone 773-285-0550
Mailing address
1406 Westchester RdBuffalo Grove, IL 60089-6880
Authorized official
Joshua David Legum
Member
5164105209
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