Healthcare Provider Details

I. General information

NPI: 1740905975
Provider Name (Legal Business Name): CEDAR HILLS HEALTH & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 16TH ST
ZION IL
60099-1423
US

IV. Provider business mailing address

2711 W HOWARD ST
CHICAGO IL
60645-1303
US

V. Phone/Fax

Practice location:
  • Phone: 847-746-8382
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL NUDELL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 847-746-8382