=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508629817
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APERION CARE LINCOLN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2024
-----------------------------------------------------
Last Update Date | 01/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1236 LINCOLN AVE
-----------------------------------------------------
City | EVANSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47714-1056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-464-3607
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4655 W CHASE AVE
-----------------------------------------------------
City | LINCOLNWOOD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60712-1605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-262-3800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF REVENUE CYCLE MANAGEMENT
-----------------------------------------------------
Name | JENNIFER SPECTOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 847-262-3800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------