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NPI Code Detail

MEDICARE: GENERATIONS AT ELMWOOD PARK, INC.

MEDICARE: GENERATIONS AT ELMWOOD PARK, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies801IL
2314000000XSkilled Nursing Facility0040410IL

General Provider Information

NPI Number : 1053316430
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATIONS AT ELMWOOD PARK, INC.
Provider Business Mailing Address
First Line : 6840 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-2628
Country : US
Telephone Number : 847-674-5200
Fax Number : 847-674-5267
Provider Business Practice Location Address
First Line : 7733 W GRAND AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1820
Country : US
Telephone Number : 708-452-9200
Fax Number : 708-452-9294
Authorized Official
Title or Position : TREASURER
Name : MR. THOMAS WINTER
Credential : CPA
Telephone Number : 847-674-5200
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/21/2022

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Directions to “GENERATIONS AT ELMWOOD PARK, INC. ” Practice Location

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