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NPI Code Detail

MEDICARE: RIDGEVIEW REHAB & NURSING CENTER, LLC

MEDICARE: RIDGEVIEW REHAB & 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 Facility0009035IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821005844
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDGEVIEW REHAB & NURSING CENTER, LLC
Provider Business Mailing Address
First Line : 3737 W ARTHUR AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-4029
Country : US
Telephone Number : 847-679-2121
Fax Number : 847-679-2122
Provider Business Practice Location Address
First Line : 6450 N RIDGE BLVD
Second Line :
City : CHICAGO
State : IL
Zip : 60626-4804
Country : US
Telephone Number : 773-743-8700
Fax Number : 773-743-8407
Authorized Official
Title or Position : MANAGER
Name : MR. JEFFREY WEBSTER
Credential :
Telephone Number : 84767992121
Provider Enumeration Date : 08/02/2006
Last Update Date : 12/16/2008

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