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NPI Code Detail

MEDICARE: FOREST CITY REHAB AND NURSING CENTER, LLC

MEDICARE: FOREST CITY REHAB AND NURSING 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 Facility

General Provider Information

NPI Number : 1588074363
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOREST CITY REHAB AND NURSING CENTER, LLC
Provider Business Mailing Address
First Line : 8153 LAWNDALE AVE
Second Line :
City : SKOKIE
State : IL
Zip : 60076-3321
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 321 ARNOLD AVE
Second Line :
City : ROCKFORD
State : IL
Zip : 61108-2315
Country : US
Telephone Number : 815-397-5531
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : SHIMON WEBSTER
Credential :
Telephone Number : 773-945-1000
Provider Enumeration Date : 05/02/2014
Last Update Date : 12/22/2015

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