MEDICARE: DOLTON NURSING & REHAB, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1689216582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLTON NURSING & REHAB, LLC

Provider Business Mailing Address
First Line	:	4655 W CHASE AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-1605
Country	:	US
Telephone Number	:	847-262-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	14325 BLACKSTONE AVE
Second Line	:
City	:	DOLTON
State	:	IL
Zip	:	60419-1323
Country	:	US
Telephone Number	:	708-849-5000
Fax Number	:

Authorized Official
Title or Position	:	VP OF REVENUE CYCLE MANAGEMENT
Name	:	JENNIFER SPECTOR
Credential	:
Telephone Number	:	847-262-3800

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	09/25/2025

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