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NPI Code Detail

MEDICARE: OAKTON PAVILLION, INC.

MEDICARE: OAKTON PAVILLION, 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
1314000000XSkilled Nursing Facility0025056IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710974993
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKTON PAVILLION, INC.
Provider Business Mailing Address
First Line : 1660 OAKTON PL
Second Line :
City : DES PLAINES
State : IL
Zip : 60018-2045
Country : US
Telephone Number : 847-299-5588
Fax Number : 847-493-6525
Provider Business Practice Location Address
First Line : 1660 OAKTON PL
Second Line :
City : DES PLAINES
State : IL
Zip : 60018-2045
Country : US
Telephone Number : 847-299-5588
Fax Number : 847-493-6525
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JAY LEWKOWITZ
Credential : CNHA
Telephone Number : 847-299-5588
Provider Enumeration Date : 10/03/2005
Last Update Date : 12/05/2011

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Directions to “OAKTON PAVILLION, INC. ” Practice Location

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