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General NPI Number Information
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NPI Number | 1649139288
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Entity Type | Organization
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Legal Business Name | MONTCLAIR SENIOR LIVING AND MEMORY CARE LLC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 5520 LINCOLN AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-3416
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Country | US
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Telephone | 224-388-1439
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Fax |
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Provider Business Mailing Address
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Address Line | 550 E DEVON AVE STE 110
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City | ITASCA
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State | IL
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Zip | 60143-2637
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HARDIK PATEL
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Credential |
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Telephone | 224-388-1439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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