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NPI Code Detail

MEDICARE: ELGIN NH LLC

MEDICARE: ELGIN NH 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

General Provider Information

NPI Number : 1366985087
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELGIN NH LLC
Provider Business Mailing Address
First Line : 2355 ROYAL BLVD
Second Line :
City : ELGIN
State : IL
Zip : 60123-4716
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2355 ROYAL BLVD
Second Line :
City : ELGIN
State : IL
Zip : 60123-4716
Country : US
Telephone Number : 847-888-9585
Fax Number : 847-888-4173
Authorized Official
Title or Position : PRESIDENT
Name : JAMES MASON
Credential :
Telephone Number : 813-347-7425
Provider Enumeration Date : 11/29/2016
Last Update Date : 06/25/2021

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Directions to “ELGIN NH LLC ” Practice Location

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