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General NPI Number Information
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NPI Number | 1093019770
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Entity Type | Organization
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Legal Business Name | CC PDR SILVERSTONE L L C
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 22605 N 74TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7466
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Country | US
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Telephone | 480-478-6200
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Fax | 480-478-6297
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Provider Business Mailing Address
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Address Line | 233 S WACKER DR STE 8400
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City | CHICAGO
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State | IL
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Zip | 60606-6316
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Country | US
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Telephone | 312-803-8800
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Fax |
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Authorized Official
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Title or Position | COUNSEL
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Name | TOMEK J KOSZYLKO
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Credential |
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Telephone | 312-803-8443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NCI-2695
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License Number State | AZ
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