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General NPI Number Information
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NPI Number | 1104828912
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Entity Type | Organization
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Legal Business Name | SL LINCOLNWOOD LLC
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 7000 N MCCORMICK BLVD
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-2726
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Country | US
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Telephone | 847-673-7166
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Fax | 847-673-5872
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Provider Business Mailing Address
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Address Line | 7000 N MCCORMICK BLVD
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-2726
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Country | US
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Telephone | 847-673-7166
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Fax | 847-673-5872
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. STEPHEN J LEVY
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Credential | RN
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Telephone | 312-673-4333
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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 | 0045963
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License Number State | IL
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