MEDICARE: HICKORY VILLAGE NURSING AND REHABILITATION CENTER 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1417688649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HICKORY VILLAGE NURSING AND REHABILITATION CENTER LLC

Provider Business Mailing Address
First Line	:	8707 SKOKIE BLVD
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-2269
Country	:	US
Telephone Number	:	773-896-6723
Fax Number	:

Provider Business Practice Location Address
First Line	:	9246 S ROBERTS RD
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-2066
Country	:	US
Telephone Number	:	708-598-4040
Fax Number	:	708-598-3796

Authorized Official
Title or Position	:	MEMBER
Name	:	DAVID MASHIACH
Credential	:
Telephone Number	:	773-896-6723

Provider Enumeration Date	:	06/20/2022
Last Update Date	:	10/03/2022

Similar Medicare Providers

1710971288 — HICKORY NURSING PAVILION
Practice Location Address:

9246 S ROBERTS RD
HICKORY HILLS, IL
60457-2066

Practice Phone: 708-598-4040
Practice Fax: 708-598-3796

1063713964 — LUTHER HILL OREGON
Practice Location Address:

2472 LUTHER HILLS CIR
OREGON, OH
43616-2066

Practice Phone: 419-697-9397
Practice Fax:

1861916942 — AMINATA CONDE
Practice Location Address:

3933 WARNER AVE APT D1
LANDOVER HILLS, MD
20784-2066

Practice Phone: 240-876-2284
Practice Fax:

1689261265 — CREATING PATHWAYS LLC
Practice Location Address:

2066 JUPITER HILLS LN
HENDERSON, NV
89012-3283

Practice Phone: 909-576-2224
Practice Fax:

1932874146 — CHRISTOPHER DOMENIC SZELONG PHARMD
Practice Location Address:

6200 SALTSBURG RD
PENN HILLS, PA
15235-2066

Practice Phone: 412-798-0490
Practice Fax:

1376354068 — LEDWINE ESONG
Practice Location Address:

3933 WARNER AVE
LANDOVER HILLS, MD
20784-2066

Practice Phone: 240-764-9358
Practice Fax:

Directions to “HICKORY VILLAGE NURSING AND REHABILITATION CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.