Healthcare Provider Details
I. General information
NPI: 1366456261
Provider Name (Legal Business Name): RIDGEVIEW REHAB & NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6450 N RIDGE BLVD
CHICAGO IL
60626-4804
US
IV. Provider business mailing address
3737 W ARTHUR AVE
LINCOLNWOOD IL
60712-4029
US
V. Phone/Fax
- Phone: 773-742-8700
- Fax:
- Phone: 847-679-2121
- Fax:
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.
JEFFREY
WEBSTER
Title or Position: PRES
Credential:
Phone: 847-679-2121