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NPI Code Detail

MEDICARE: LAKEVIEW REHABILITATION AND NURSING CENTER

MEDICARE: LAKEVIEW REHABILITATION AND NURSING 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
1314000000XSkilled Nursing Facility0051524IL

General Provider Information

NPI Number : 1558642314
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEVIEW REHABILITATION AND NURSING CENTER
Provider Business Mailing Address
First Line : 735 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2337
Country : US
Telephone Number : 773-348-4055
Fax Number :
Provider Business Practice Location Address
First Line : 735 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2337
Country : US
Telephone Number : 773-348-4055
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MOISHE GUBIN
Credential :
Telephone Number : 708-449-1900
Provider Enumeration Date : 09/06/2011
Last Update Date : 09/06/2011

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Directions to “LAKEVIEW REHABILITATION AND NURSING CENTER ” Practice Location

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