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General NPI Number Information
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NPI Number | 1417942384
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Entity Type | Organization
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Legal Business Name | MARGARET MANOR INC.
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 1121 N ORLEANS ST
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City | CHICAGO
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State | IL
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Zip | 60610
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Country | US
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Telephone | 312-943-4300
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Fax | 312-943-4304
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Provider Business Mailing Address
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Address Line | 405 N WABASH AVE STE P2W
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City | CHICAGO
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State | IL
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Zip | 60611-3541
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Country | US
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Telephone | 312-787-9400
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Fax | 312-787-9434
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PETER J O'BRIEN
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Credential |
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Telephone | 312-787-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 0011239
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License Number State | IL
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