MEDICARE: WESTWOOD MANOR, INC.

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	5249	IL

General Provider Information

NPI Number	:	1528054350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTWOOD MANOR, INC.

Provider Business Mailing Address
First Line	:	2444 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3310
Country	:	US
Telephone Number	:	773-274-7705
Fax Number	:	773-274-6173

Provider Business Practice Location Address
First Line	:	2444 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3310
Country	:	US
Telephone Number	:	773-274-7705
Fax Number	:	773-274-6173

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. JOSEPH LIBERMAN
Credential	:	PH.D.
Telephone Number	:	773-274-7705

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	08/18/2016

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