Healthcare Provider Details

I. General information

NPI: 1295086148
Provider Name (Legal Business Name): PARK VIEW REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5888 N RIDGE AVE
CHICAGO IL
60660-3450
US

IV. Provider business mailing address

5888 N RIDGE AVE
CHICAGO IL
60660-3450
US

V. Phone/Fax

Practice location:
  • Phone: 773-769-2626
  • Fax: 773-769-2650
Mailing address:
  • Phone: 773-769-2626
  • Fax: 773-769-2650

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: MS. FRANCES MEEHAN
Title or Position: ATTORNEY
Credential:
Phone: 312-521-2467