Healthcare Provider Details

I. General information

NPI: 1467012807
Provider Name (Legal Business Name): COUNCIL FOR JEWISH ELDERLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 LAKE COOK RD
DEERFIELD IL
60015-5271
US

IV. Provider business mailing address

3003 W TOUHY AVE
CHICAGO IL
60645-2833
US

V. Phone/Fax

Practice location:
  • Phone: 773-508-1000
  • Fax:
Mailing address:
  • Phone: 773-508-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACEY LEE TURNER
Title or Position: CFO
Credential:
Phone: 773-508-1075