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Organization
ELISABETH LUDEMAN CENTER
Active
Organization
ELISABETH LUDEMAN CENTER
Active
Other names
House 35
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJANI PATWARI M.D. (MEDICAL DIRECTOR)
(708) 283-3011
Entity
Organization
Contact information
Practice address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Mailing address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000950335001
—
IL
Enumeration date
05/07/2007
Last updated
08/22/2020
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