Healthcare Provider Details

I. General information

NPI: 1366573404
Provider Name (Legal Business Name): AURORA SUPPORTIVE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1599 N FARNSWORTH AVE
AURORA IL
60505-1530
US

IV. Provider business mailing address

4711 MIDLOTHIAN TPKE SUITE 20
CRESTWOOD IL
60445-4900
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-9400
  • Fax: 630-898-9420
Mailing address:
  • Phone: 708-371-4507
  • Fax: 708-371-1761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: PATRICK FINN
Title or Position: MEMBER
Credential:
Phone: 847-229-3400