Healthcare Provider Details

I. General information

NPI: 1003897893
Provider Name (Legal Business Name): WARREN BARR NURSING PAVILION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W OAK ST
CHICAGO IL
60610-7325
US

IV. Provider business mailing address

6400 SHAFER CT SUITE 600
ROSEMONT IL
60018-4914
US

V. Phone/Fax

Practice location:
  • Phone: 312-705-5100
  • Fax: 312-337-5041
Mailing address:
  • Phone: 847-720-8722
  • Fax: 847-720-8701

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: MR. NEELE E. STEARNS
Title or Position: CHAIRMAN
Credential:
Phone: 847-720-8720