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NPI Code Detail

MEDICARE: SHERIDAN SHORES CARE & REHABILITATION CENTER

MEDICARE: SHERIDAN SHORES CARE & REHABILITATION CENTER
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
1313M00000XNursing Facility/Intermediate Care Facility0040444IL
2314000000XSkilled Nursing Facility0040444IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11129OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1942325253
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN SHORES CARE & REHABILITATION CENTER
Provider Business Mailing Address
First Line : 5838 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-4916
Country : US
Telephone Number : 773-769-2230
Fax Number : 773-769-3579
Provider Business Practice Location Address
First Line : 5838 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-4916
Country : US
Telephone Number : 773-769-2230
Fax Number : 773-769-3579
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MR. MARK STEINBERG
Credential :
Telephone Number : 847-905-3000
Provider Enumeration Date : 03/20/2007
Last Update Date : 04/20/2008

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Directions to “SHERIDAN SHORES CARE & REHABILITATION CENTER ” Practice Location

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