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NPI Code Detail

MEDICARE: GENERATIONS AT NEIGHBORS LLC

MEDICARE: GENERATIONS AT NEIGHBORS 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 Facility0049973IL

General Provider Information

NPI Number : 1598754764
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATIONS AT NEIGHBORS LLC
Provider Business Mailing Address
First Line : PO BOX 585
Second Line :
City : BYRON
State : IL
Zip : 61010-0585
Country : US
Telephone Number : 815-234-2511
Fax Number : 815-234-5168
Provider Business Practice Location Address
First Line : 811 W 2ND ST
Second Line :
City : BYRON
State : IL
Zip : 61010-1464
Country : US
Telephone Number : 815-234-2511
Fax Number : 815-234-5168
Authorized Official
Title or Position : CFO
Name : MR. THOMAS WINTER
Credential :
Telephone Number : 847-674-5200
Provider Enumeration Date : 10/19/2005
Last Update Date : 08/03/2022

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Directions to “GENERATIONS AT NEIGHBORS LLC ” Practice Location

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