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General NPI Number Information
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NPI Number | 1588713788
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Entity Type | Organization
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Legal Business Name | LITTLE SISTERS OF THE POOR ST JOSEPHS HOME FOR THE ELDERLY
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 80 W NORTHWEST HWY
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City | PALATINE
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State | IL
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Zip | 60067-3582
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Country | US
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Telephone | 847-358-5700
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Fax | 847-358-9761
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Provider Business Mailing Address
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Address Line | 80 W NORTHWEST HWY
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City | PALATINE
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State | IL
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Zip | 60067-3582
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Country | US
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Telephone | 847-358-5700
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Fax | 847-358-9761
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARGARET HOGARTY
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Credential | SISTER
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Telephone | 847-358-5700
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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 | 0027045
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License Number State | IL
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