Healthcare Provider Details

I. General information

NPI: 1932049574
Provider Name (Legal Business Name): LANDMARK OF LINCOLN PARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 W DIVERSEY PKWY
CHICAGO IL
60614-2337
US

IV. Provider business mailing address

240 FENCL LN
HILLSIDE IL
60162-2067
US

V. Phone/Fax

Practice location:
  • Phone: 773-348-4055
  • Fax:
Mailing address:
  • Phone: 708-449-1900
  • Fax:

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: JEFFREY SAX
Title or Position: MANAGER
Credential:
Phone: 269-281-4200