Healthcare Provider Details

I. General information

NPI: 1245004142
Provider Name (Legal Business Name): NORTHBROOK HEALTH AND REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 LAKE COOK RD
NORTHBROOK IL
60062-1112
US

IV. Provider business mailing address

5454 FARGO AVE
SKOKIE IL
60077-3210
US

V. Phone/Fax

Practice location:
  • Phone: 847-562-1770
  • Fax:
Mailing address:
  • Phone: 847-983-4860
  • 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: DAVID MERZEL
Title or Position: CFO
Credential:
Phone: 847-983-4860