MEDICARE: OREGON HEALTHCARE CENTER

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	0037838	IL

General Provider Information

NPI Number	:	1447224423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OREGON HEALTHCARE CENTER

Provider Business Mailing Address
First Line	:	7434 SKOKIE BLVD
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-3341
Country	:	US
Telephone Number	:	847-982-2300
Fax Number	:	847-982-2304

Provider Business Practice Location Address
First Line	:	811 S 10TH ST
Second Line	:
City	:	OREGON
State	:	IL
Zip	:	61061-2129
Country	:	US
Telephone Number	:	815-732-7994
Fax Number	:	815-732-7998

Authorized Official
Title or Position	:	COMPTROLLER
Name	:	MOE HERMAN
Credential	:
Telephone Number	:	847-982-2300

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/13/2009

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Directions to “OREGON HEALTHCARE CENTER ” Practice Location

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