Healthcare Provider Details
I. General information
NPI: 1851816482
Provider Name (Legal Business Name): APERION CARE FAIRFIELD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2017
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
305 NW 11TH ST
FAIRFIELD IL
62837-1203
US
IV. Provider business mailing address
4655 W CHASE AVE
LINCOLNWOOD IL
60712-1605
US
V. Phone/Fax
- Phone: 618-842-3036
- Fax:
- Phone:
- 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 | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YOSEF
MEYSTEL
Title or Position: MANAGER
Credential:
Phone: 847-262-3800