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NPI Code Detail

MEDICARE: CENTRAL NURSING AND REHABILITATION CENTER LLC

MEDICARE: CENTRAL NURSING AND 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
1314000000XSkilled Nursing Facility50526IL

General Provider Information

NPI Number : 1285969584
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL NURSING AND REHABILITATION CENTER LLC
Provider Business Mailing Address
First Line : 2450 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1316
Country : US
Telephone Number : 773-889-1333
Fax Number : 773-622-6196
Provider Business Practice Location Address
First Line : 2450 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1316
Country : US
Telephone Number : 773-889-1333
Fax Number : 773-622-6196
Authorized Official
Title or Position : CONTROLLER
Name : DOLLY FORD
Credential :
Telephone Number : 773-889-1333
Provider Enumeration Date : 10/05/2009
Last Update Date : 10/05/2009

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Directions to “CENTRAL NURSING AND REHABILITATION CENTER LLC ” Practice Location

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