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NPI Code Detail

MEDICARE: COMMUNITY CARE CENTER

MEDICARE: COMMUNITY CARE CENTER
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
1314000000XSkilled Nursing Facility0029132IL

General Provider Information

NPI Number : 1083664304
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY CARE CENTER
Provider Business Mailing Address
First Line : 6865 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-4611
Country : US
Telephone Number : 847-674-5795
Fax Number : 847-674-5794
Provider Business Practice Location Address
First Line : 4314 S WABASH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3119
Country : US
Telephone Number : 773-538-8300
Fax Number : 773-538-5775
Authorized Official
Title or Position : CEO
Name : MR. AVRUM WEINFELD
Credential :
Telephone Number : 847-674-5795
Provider Enumeration Date : 05/10/2006
Last Update Date : 08/22/2020

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Directions to “COMMUNITY CARE CENTER ” Practice Location

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