Healthcare Provider Details

I. General information

NPI: 1902875974
Provider Name (Legal Business Name): MST HEALTH PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 26TH ST
SOUTH CHICAGO HEIGHTS IL
60411-4141
US

IV. Provider business mailing address

5151 CHURCH ST
SKOKIE IL
60077-1123
US

V. Phone/Fax

Practice location:
  • Phone: 708-756-5200
  • Fax: 708-709-3142
Mailing address:
  • Phone: 847-933-9200
  • Fax: 847-933-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0043406
License Number StateIL

VIII. Authorized Official

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