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General NPI Number Information
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NPI Number | 1417647157
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Entity Type | Organization
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Legal Business Name | PEARL OF EVANSTON, LLC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 820 FOSTER ST
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City | EVANSTON
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State | IL
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Zip | 60201-3212
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Country | US
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Telephone | 847-492-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 4711 GOLF RD STE 200
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City | SKOKIE
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State | IL
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Zip | 60076-1236
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Country | US
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Telephone | 847-933-9280
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EITAN ZEFFREN
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Credential |
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Telephone | 847-492-7700
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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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