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General NPI Number Information
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NPI Number | 1538153374
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Entity Type | Organization
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Legal Business Name | LEXINGTON HEALTH CARE CENTER OF CHICAGO RIDGE INC
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 10300 SOUTHWEST HWY
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-1426
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Country | US
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Telephone | 708-425-1100
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Fax | 708-425-0779
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Provider Business Mailing Address
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Address Line | 665 W NORTH AVE SUITE 500
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City | LOMBARD
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State | IL
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Zip | 60148-1134
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Country | US
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Telephone | 630-458-4700
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Fax | 630-458-4770
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. SUSAN ROJEK
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Credential | CPA
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Telephone | 630-458-4780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0042739
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0042739
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License Number State | IL
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