Healthcare Provider Details
I. General information
NPI: 1356750269
Provider Name (Legal Business Name): S-H OPCO PROSPECT HEIGHTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2014
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 E EUCLID AVE
PROSPECT HEIGHTS IL
60070-3409
US
IV. Provider business mailing address
700 E EUCLID AVE
PROSPECT HEIGHTS IL
60070-3409
US
V. Phone/Fax
- Phone: 847-797-2700
- Fax: 847-797-2705
- Phone: 847-797-2700
- Fax: 847-797-2705
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
SPRAGINS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 206-728-9063