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NPI Code Detail

MEDICARE: GROVE OF NORTHBROOK LIVING & REHAB CENTER LLC

MEDICARE: GROVE OF NORTHBROOK LIVING & REHAB 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1659624112
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROVE OF NORTHBROOK LIVING & REHAB CENTER LLC
Provider Business Mailing Address
First Line : 7040 N RIDGEWAY AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-2620
Country : US
Telephone Number : 847-679-9797
Fax Number : 847-679-1126
Provider Business Practice Location Address
First Line : 263 SKOKIE BLVD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1611
Country : US
Telephone Number : 847-564-0505
Fax Number :
Authorized Official
Title or Position : AR MANAGER
Name : REUVEN LEVITIN
Credential :
Telephone Number : 847-676-5342
Provider Enumeration Date : 10/22/2012
Last Update Date : 10/22/2012

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Directions to “GROVE OF NORTHBROOK LIVING & REHAB CENTER LLC ” Practice Location

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