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NPI Code Detail

MEDICARE: SHERIDAN HEALTH CARE ASSOCIATE

MEDICARE: SHERIDAN HEALTH CARE ASSOCIATE
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
1314000000XSkilled Nursing Facility0027680IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25414OTHERILBCBS

General Provider Information

NPI Number : 1235135930
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN HEALTH CARE ASSOCIATE
Provider Business Mailing Address
First Line : 2534 ELIM AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2661
Country : US
Telephone Number : 847-746-8435
Fax Number : 847-746-1744
Provider Business Practice Location Address
First Line : 2534 ELIM AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2661
Country : US
Telephone Number : 847-746-8435
Fax Number : 847-746-1744
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. JULIE A. STANGEL
Credential : L.P.N.
Telephone Number : 847-746-8435
Provider Enumeration Date : 06/27/2005
Last Update Date : 03/11/2009

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Directions to “SHERIDAN HEALTH CARE ASSOCIATE ” Practice Location

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