MEDICARE: PATHWAY MANAGEMENT LAKE ZURICH, 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1700326295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY MANAGEMENT LAKE ZURICH, LLC

Provider Business Mailing Address
First Line	:	333 W WACKER DR
Second Line	:	SUITE 1010
City	:	CHICAGO
State	:	IL
Zip	:	60606-1220
Country	:	US
Telephone Number	:	312-837-0701
Fax Number	:	312-837-0728

Provider Business Practice Location Address
First Line	:	795 N RAND RD
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-2488
Country	:	US
Telephone Number	:	847-438-6100
Fax Number	:

Authorized Official
Title or Position	:	RISK MANAGER
Name	:	KRISTEN BECHT
Credential	:
Telephone Number	:	312-837-0710

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	04/11/2019

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