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General NPI Number Information
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NPI Number | 1003924721
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Entity Type | Organization
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Legal Business Name | EVANGELICAL RETIREMENT HOMES OF GREATER CHICAGO, INC.
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 350 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3464
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Country | US
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Telephone | 847-884-5000
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Fax | 847-884-5718
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Provider Business Mailing Address
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Address Line | 350 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3464
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Country | US
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Telephone | 847-884-5000
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Fax | 847-884-5718
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Authorized Official
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Title or Position | V.P./ CFO
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Name | MR. MICHAEL A FLYNN
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Credential |
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Telephone | 847-884-5371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 000023218
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0023218
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License Number State | IL
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