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NPI Code Detail

MEDICARE: S-H OPCO PROSPECT HEIGHTS, LLC

MEDICARE: S-H OPCO PROSPECT HEIGHTS, 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 Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10052886OTHERILSTATE OF IL IDPH

General Provider Information

NPI Number : 1356750269
Entity Type Code : Organization
Provider Name (Legal Business Name) : S-H OPCO PROSPECT HEIGHTS, LLC
Provider Business Mailing Address
First Line : 700 E EUCLID AVE
Second Line :
City : PROSPECT HEIGHTS
State : IL
Zip : 60070-3409
Country : US
Telephone Number : 847-797-2700
Fax Number : 847-797-2705
Provider Business Practice Location Address
First Line : 700 E EUCLID AVE
Second Line :
City : PROSPECT HEIGHTS
State : IL
Zip : 60070-3409
Country : US
Telephone Number : 847-797-2700
Fax Number : 847-797-2705
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : ALAN SPRAGINS
Credential :
Telephone Number : 206-728-9063
Provider Enumeration Date : 08/05/2014
Last Update Date : 01/06/2021

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Directions to “S-H OPCO PROSPECT HEIGHTS, LLC ” Practice Location

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