MEDICARE: BROOKSTONE ESTATES OF OLNEY

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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1366103731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKSTONE ESTATES OF OLNEY

Provider Business Mailing Address
First Line	:	222 S RIVERSIDE PLZ FL 20
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60606-5808
Country	:	US
Telephone Number	:	312-837-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 N EAST ST
Second Line	:
City	:	OLNEY
State	:	IL
Zip	:	62450-6902
Country	:	US
Telephone Number	:	618-392-5870
Fax Number	:

Authorized Official
Title or Position	:	RISK MANAGER
Name	:	KRISTEN BECHT
Credential	:
Telephone Number	:	312-837-0710

Provider Enumeration Date	:	01/06/2022
Last Update Date	:	01/06/2022

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Directions to “BROOKSTONE ESTATES OF OLNEY ” Practice Location

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