Healthcare Provider Details
I. General information
NPI: 1215280045
Provider Name (Legal Business Name): FOREST EDGE HEALTHCARE & REHABILITATION CENTER, LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2012
Last Update Date: 10/16/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8001 S WESTERN AVE
CHICAGO IL
60620-5930
US
IV. Provider business mailing address
5151 CHURCH ST
SKOKIE IL
60077-1123
US
V. Phone/Fax
- Phone: 773-436-6600
- Fax: 773-471-1661
- Phone: 847-933-9200
- Fax: 847-933-9765
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
AVRUM
WEINFELD
Title or Position: CFO
Credential:
Phone: 847-933-9200