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General NPI Number Information
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NPI Number | 1649395971
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Entity Type | Organization
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Legal Business Name | ASPIRE OF ILLINOIS
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 105 EASTERN AVE
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City | BELLWOOD
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State | IL
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Zip | 60104-1220
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Country | US
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Telephone | 708-547-3550
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Fax | 708-547-4067
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Provider Business Mailing Address
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Address Line | 9901 DERBY LN
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City | WESTCHESTER
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State | IL
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Zip | 60154-3709
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Country | US
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Telephone | 708-547-3550
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Fax | 708-547-4067
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Authorized Official
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Title or Position | VP OF BUSINESS ADMININSTATION
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Name | JAMES B O'BRIEN
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Credential |
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Telephone | 708-547-3550
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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 |
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License Number State |
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