Healthcare Provider Details

I. General information

NPI: 1689228603
Provider Name (Legal Business Name): ELEVATE WOODVIEW NURSING AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 E STATE BLVD
FORT WAYNE IN
46805-5605
US

IV. Provider business mailing address

7366 N LINCOLN AVE STE 301
LINCOLNWOOD IL
60712-1740
US

V. Phone/Fax

Practice location:
  • Phone: 260-484-3120
  • Fax: 260-482-1434
Mailing address:
  • Phone: 224-470-2657
  • Fax: 224-433-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AMIRA KRVAVAC
Title or Position: AR DIRECTOR
Credential:
Phone: 224-470-2657