MEDICARE: SENECA NURSING HOME, INC.

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1043666738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENECA NURSING HOME, INC.

Provider Business Mailing Address
First Line	:	1301 LEE ST
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-1514
Country	:	US
Telephone Number	:	847-635-4000
Fax Number	:	847-635-5016

Provider Business Practice Location Address
First Line	:	1301 LEE ST
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-1514
Country	:	US
Telephone Number	:	847-635-4000
Fax Number	:	847-635-5016

Authorized Official
Title or Position	:	OWNER
Name	:	CHESTER PLODZIEN
Credential	:
Telephone Number	:	847-635-4000

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	05/11/2016

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Directions to “SENECA NURSING HOME, INC. ” Practice Location

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