Healthcare Provider Details

I. General information

NPI: 1821085291
Provider Name (Legal Business Name): ALDEN-NORTHMOOR REHABILITATION AND HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5831 N NORTHWEST HWY
CHICAGO IL
60631-2642
US

IV. Provider business mailing address

4200 W PETERSON AVE SUITE 140
CHICAGO IL
60646-6074
US

V. Phone/Fax

Practice location:
  • Phone: 773-775-8080
  • Fax: 773-775-9672
Mailing address:
  • Phone: 773-286-6622
  • Fax: 773-286-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0041277
License Number StateIL

VIII. Authorized Official

Name: FLOYD A SCHLOSSBERG
Title or Position: PRESIDENT
Credential:
Phone: 773-286-6622