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General NPI Number Information
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NPI Number | 1750351425
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Entity Type | Organization
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Legal Business Name | WESTMINSTER PLACE
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 3200 GRANT ST
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City | EVANSTON
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State | IL
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Zip | 60201-1903
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Country | US
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Telephone | 847-492-4871
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Fax | 847-570-3426
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Provider Business Mailing Address
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Address Line | 8707 SKOKIE BLVD STE 400
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City | SKOKIE
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State | IL
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Zip | 60077-2283
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Country | US
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Telephone | 847-979-3955
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Fax | 847-979-3969
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MARK E. HAVRILKA
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Credential |
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Telephone | 847-979-3904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0012930
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0012930
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License Number State | IL
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