MEDICARE: CHICAGO-BARTON, 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1508894981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO-BARTON, LLC

Provider Business Mailing Address
First Line	:	465 CENTRAL AVE
Second Line	:	SUITE 100
City	:	NORTHFIELD
State	:	IL
Zip	:	60093-3045
Country	:	US
Telephone Number	:	847-441-8200
Fax Number	:	847-441-0800

Provider Business Practice Location Address
First Line	:	1245 S WOOD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1943
Country	:	US
Telephone Number	:	312-421-5220
Fax Number	:	312-421-2951

Authorized Official
Title or Position	:	CFO COO
Name	:	RICHARD DEAN DUROS
Credential	:
Telephone Number	:	847-441-8200

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/14/2008

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