MEDICARE: ALSHORE HOUSE 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	313M00000X	Nursing Facility/Intermediate Care Facility	0004754	IL

General Provider Information

NPI Number	:	1841320850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALSHORE HOUSE INC.

Provider Business Mailing Address
First Line	:	2840 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3506
Country	:	US
Telephone Number	:	773-561-2040
Fax Number	:	773-561-2060

Provider Business Practice Location Address
First Line	:	2840 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3506
Country	:	US
Telephone Number	:	773-561-2040
Fax Number	:	773-561-2060

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PAMELA SOLOMON
Credential	:
Telephone Number	:	773-561-2040

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/22/2020

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