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General NPI Number Information
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NPI Number | 1689310138
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Entity Type | Organization
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Legal Business Name | DOWNERS GROVE SNF OPERATIONS LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 3450 SARATOGA AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1141
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Country | US
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Telephone | 630-576-9719
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 SARATOGA AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1141
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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 | VICE PRESIDENT OF COST CONTAINMENT
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Name | JOSEPH LIEBERMAN
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Credential |
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Telephone | 646-275-4510
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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 |
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License Number State |
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