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NPI Code Detail

MEDICARE: LAKEVIEW NURSING AND REHABILITATION CENTRE INC

MEDICARE: LAKEVIEW NURSING AND REHABILITATION CENTRE 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
1314000000XSkilled Nursing Facility1764042IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1959OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1295805521
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEVIEW NURSING AND REHABILITATION CENTRE INC
Provider Business Mailing Address
First Line : 735 WEST DIVERSEY PARKWAY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2337
Country : US
Telephone Number : 773-348-4055
Fax Number : 773-348-6259
Provider Business Practice Location Address
First Line : 735 WEST DIVERSEY PARKWAY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2337
Country : US
Telephone Number : 773-348-4055
Fax Number : 773-348-6259
Authorized Official
Title or Position : PRESIDENT 50 PERCENT OWNER
Name : MR. SAM BOREK
Credential :
Telephone Number : 847-256-7600
Provider Enumeration Date : 11/08/2006
Last Update Date : 04/20/2008

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1558642314 — LAKEVIEW REHABILITATION AND NURSING CENTER
Practice Location Address:
735 W DIVERSEY PKWY
CHICAGO, IL
60614-2337
Practice Phone: 773-348-4055
Practice Fax:
1730669961 — KYLEIGH E SEIBERT
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1770065690 — HANNAH L GREENING MS CCC SLP
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CHICAGO, IL
60614-2337
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Practice Fax:
1659840973 — ABBEY ELIZABETH METZLER LCSW
Practice Location Address:
735 W DIVERSEY PKWY
CHICAGO, IL
60614-2337
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Practice Fax:
1437892585 — JESSICA ANN MICHALEC COTA/L
Practice Location Address:
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CHICAGO, IL
60614-2337
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Practice Fax:
1659191500 — ARIANNA JOVON HARVEY OTR/L
Practice Location Address:
735 W DIVERSEY PKWY
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60614-2337
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Practice Fax:

Directions to “LAKEVIEW NURSING AND REHABILITATION CENTRE INC ” Practice Location

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