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NPI Code Detail

MEDICARE: NUGLEN, LLC

MEDICARE: NUGLEN, 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 FacilityWI

General Provider Information

NPI Number : 1851644470
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUGLEN, LLC
Provider Business Mailing Address
First Line : 7257 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-1810
Country : US
Telephone Number : 847-933-2600
Fax Number : 847-745-0915
Provider Business Practice Location Address
First Line : 6263 N GREEN BAY AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-3823
Country : US
Telephone Number : 414-351-0543
Fax Number : 414-351-7977
Authorized Official
Title or Position : MANAGER
Name : MR. DAVID HARTMAN
Credential :
Telephone Number : 847-933-2600
Provider Enumeration Date : 10/19/2012
Last Update Date : 10/19/2012

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Directions to “NUGLEN, LLC ” Practice Location

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