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NPI Code Detail

MEDICARE: SYMPHONY OF EVANSTON HEALTHCARE LLC

MEDICARE: SYMPHONY OF EVANSTON HEALTHCARE LLC
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 FacilityIL

General Provider Information

NPI Number : 1093119471
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYMPHONY OF EVANSTON HEALTHCARE LLC
Provider Business Mailing Address
First Line : 820 FOSTER ST
Second Line :
City : EVANSTON
State : IL
Zip : 60201-3212
Country : US
Telephone Number : 847-492-7700
Fax Number :
Provider Business Practice Location Address
First Line : 7257 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-1810
Country : US
Telephone Number : 847-933-2600
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DAVID J HARTMAN
Credential :
Telephone Number : 847-933-2600
Provider Enumeration Date : 10/14/2014
Last Update Date : 10/14/2014

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