Healthcare Provider Details

I. General information

NPI: 1104181015
Provider Name (Legal Business Name): FOSTER HEALTH & REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 W FOSTER AVE
CHICAGO IL
60625-3506
US

IV. Provider business mailing address

2840 W FOSTER AVE
CHICAGO IL
60625-3506
US

V. Phone/Fax

Practice location:
  • Phone: 773-561-2040
  • Fax: 773-561-2060
Mailing address:
  • Phone: 773-561-2040
  • Fax: 773-561-2060

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: JUDD SCHNEIDER
Title or Position: MANAGER
Credential:
Phone: 773-919-9813