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NPI Code Detail

MEDICARE: NORRIDGE NURSING CENTRE, INC

MEDICARE: NORRIDGE NURSING CENTRE, INC
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 FacilityIL

General Provider Information

NPI Number : 1740276120
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORRIDGE NURSING CENTRE, INC
Provider Business Mailing Address
First Line : 7001 W CULLOM AVE
Second Line :
City : NORRIDGE
State : IL
Zip : 60706-7100
Country : US
Telephone Number : 708-457-0700
Fax Number : 708-457-8852
Provider Business Practice Location Address
First Line : 7001 W CULLOM AVE
Second Line :
City : NORRIDGE
State : IL
Zip : 60706-7100
Country : US
Telephone Number : 708-457-0700
Fax Number : 708-457-8852
Authorized Official
Title or Position : V.P. FINANCE
Name : MR. CHRISTOPHER VICERE
Credential :
Telephone Number : 773-604-4416
Provider Enumeration Date : 09/21/2005
Last Update Date : 08/22/2020

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