Healthcare Provider Details

I. General information

NPI: 1689643363
Provider Name (Legal Business Name): WESTMONT CONVALESCENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 S CASS AVE
WESTMONT IL
60559-3200
US

IV. Provider business mailing address

6501 S CASS AVE
WESTMONT IL
60559-3200
US

V. Phone/Fax

Practice location:
  • Phone: 630-960-2026
  • Fax: 630-960-0480
Mailing address:
  • Phone: 630-960-2026
  • Fax: 630-960-0480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0030015
License Number StateIL

VIII. Authorized Official

Name: MRS. FLORA WEISS
Title or Position: OWNER
Credential:
Phone: 847-674-5795