Healthcare Provider Details

I. General information

NPI: 1831531805
Provider Name (Legal Business Name): CHICAGO HEIGHTS SLF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 DIXIE HWY
CHICAGO HEIGHTS IL
60411-2623
US

IV. Provider business mailing address

1040 DIXIE HWY
CHICAGO HEIGHTS IL
60411-2623
US

V. Phone/Fax

Practice location:
  • Phone: 708-754-5700
  • Fax: 708-754-5734
Mailing address:
  • Phone: 708-754-5700
  • Fax: 708-754-5734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number001
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN J LEVY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 312-673-4387