Organization · NPI-2

Admiral At The Lake

Skilled Nursing Facility · Chicago, IL

NPI number1982946604
StatusActive
Last updated in NPPESJul 17, 2023

Details

NPI
1982946604
Entity type
Organization (NPI-2)
Legal business name
Admiral At The Lake
Organization subpart
No
Enumeration date
Mar 20, 2013
Certification date
Aug 25, 2021
Last updated
Jul 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility––Yes

Practice location

933 W. Foster Ave
Chicago, IL 60640

Phone 773-433-1800

Mailing address

929 W Foster Ave
Chicago, IL 60640-1491

Phone 773-433-1800

Authorized official

Chaim Dubovick
Administrator
7734331800

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