Healthcare Provider Details

I. General information

NPI: 1639385172
Provider Name (Legal Business Name): WASHINGTON AND JANE SMITH COMMUNITY- ORLAND PARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 EMILIE LN
ORLAND PARK IL
60467-8805
US

IV. Provider business mailing address

10501 EMILIE LN
ORLAND PARK IL
60467-8805
US

V. Phone/Fax

Practice location:
  • Phone: 708-226-1800
  • Fax: 708-326-2770
Mailing address:
  • Phone: 708-226-1800
  • Fax: 708-326-2770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH HART
Title or Position: CFO
Credential:
Phone: 773-474-7350