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NPI Code Detail

MEDICARE: CHURCH STREET STATION NURSING

MEDICARE: CHURCH STREET STATION NURSING
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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1871934240
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHURCH STREET STATION NURSING
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 :
Provider Business Practice Location 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 :
Authorized Official
Title or Position : CFO
Name : JAY FLATT
Credential :
Telephone Number : 847-933-2600
Provider Enumeration Date : 07/12/2013
Last Update Date : 07/12/2013

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Directions to “CHURCH STREET STATION NURSING ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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