Healthcare Provider Details

I. General information

NPI: 1538635545
Provider Name (Legal Business Name): RESILIENCE HEALTHCARE - WEST SUBURBAN MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ERIE CT
OAK PARK IL
60302-2519
US

IV. Provider business mailing address

3 ERIE CT
OAK PARK IL
60302-2519
US

V. Phone/Fax

Practice location:
  • Phone: 708-383-6200
  • Fax:
Mailing address:
  • Phone: 708-383-6200
  • 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: MANOJ PRASAD
Title or Position: CEO
Credential: MD
Phone: 708-763-6700