Healthcare Provider Details

I. General information

NPI: 1508170291
Provider Name (Legal Business Name): PALOS HILLS HEALTHCARE LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10426 S ROBERTS RD
PALOS HILLS IL
60465-1932
US

IV. Provider business mailing address

5151 CHURCH ST
SKOKIE IL
60077-1123
US

V. Phone/Fax

Practice location:
  • Phone: 708-598-3460
  • Fax: 708-598-0520
Mailing address:
  • Phone: 847-933-9200
  • Fax: 847-933-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0046029
License Number StateIL

VIII. Authorized Official

Name: MR. AVRUM WEINFELD
Title or Position: CFO
Credential:
Phone: 847-933-9200