Healthcare Provider Details

I. General information

NPI: 1891474375
Provider Name (Legal Business Name): ALPINE CARE AT ORCHARD VALLEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 W GALENA BLVD
AURORA IL
60506-4246
US

IV. Provider business mailing address

4711 GOLF RD STE 200
SKOKIE IL
60076-1236
US

V. Phone/Fax

Practice location:
  • Phone: 630-896-4686
  • Fax:
Mailing address:
  • Phone: 847-933-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ARIEL GUTNICKI
Title or Position: MANAGER
Credential:
Phone: 630-896-4686