Healthcare Provider Details

I. General information

NPI: 1508894981
Provider Name (Legal Business Name): CHICAGO-BARTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 S WOOD ST
CHICAGO IL
60608-1943
US

IV. Provider business mailing address

465 CENTRAL AVE SUITE 100
NORTHFIELD IL
60093-3045
US

V. Phone/Fax

Practice location:
  • Phone: 312-421-5220
  • Fax: 312-421-2951
Mailing address:
  • Phone: 847-441-8200
  • Fax: 847-441-0800

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: RICHARD DEAN DUROS
Title or Position: CFO COO
Credential:
Phone: 847-441-8200