MEDICARE: FOSTER HEALTH & REHABILITATION CENTER 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	:	1104181015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOSTER HEALTH & REHABILITATION CENTER LLC

Provider Business Mailing Address
First Line	:	2840 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3506
Country	:	US
Telephone Number	:	773-561-2040
Fax Number	:	773-561-2060

Provider Business Practice Location Address
First Line	:	2840 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3506
Country	:	US
Telephone Number	:	773-561-2040
Fax Number	:	773-561-2060

Authorized Official
Title or Position	:	MANAGER
Name	:	JUDD SCHNEIDER
Credential	:
Telephone Number	:	773-919-9813

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	02/17/2016

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