Healthcare Provider Details

I. General information

NPI: 1831409879
Provider Name (Legal Business Name): OAK LAWN RESPIRATORY AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 MAYFIELD AVE
OAK LAWN IL
60453-2817
US

IV. Provider business mailing address

9525 MAYFIELD AVE
OAK LAWN IL
60453-2817
US

V. Phone/Fax

Practice location:
  • Phone: 708-636-7000
  • Fax:
Mailing address:
  • Phone: 708-636-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MOISHE GUBIN
Title or Position: OWNER
Credential:
Phone: 708-636-7000