MEDICARE: ALDEN-PRINCETON REHABILITATION AND HEALTH CARE CENTER, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	314000000X	Skilled Nursing Facility	0036244	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1008	OTHER	IL	BLUE CROSS

General Provider Information

NPI Number	:	1760479679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALDEN-PRINCETON REHABILITATION AND HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	4200 W PETERSON AVE
Second Line	:	SUITE 140
City	:	CHICAGO
State	:	IL
Zip	:	60646-6074
Country	:	US
Telephone Number	:	773-286-6622
Fax Number	:	773-286-2150

Provider Business Practice Location Address
First Line	:	255 W 69TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3767
Country	:	US
Telephone Number	:	773-224-5900
Fax Number	:	773-224-7157

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FLOYD A SCHLOSSBERG
Credential	:
Telephone Number	:	773-286-6622

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	11/12/2015

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