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General NPI Number Information
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NPI Number | 1356297105
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Entity Type | Organization
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Legal Business Name | THRYVE OF CRESTWOOD LLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 14255 CICERO AVE
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City | CRESTWOOD
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State | IL
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Zip | 60418-2154
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Country | US
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Telephone | 708-371-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 MCCORMICK BLVD STE 138
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City | SKOKIE
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State | IL
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Zip | 60076-2920
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICARE AUTHORIZED OFFICIAL
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Name | EFRIAM WEINFELD
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Credential |
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Telephone | 224-536-4202
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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 |
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License Number State |
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