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Organization
KINDRED THC CHICAGO, LLC
Active
Organization
KINDRED THC CHICAGO, LLC
Active
Other names
Kindred Hospital - Chicago
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE K. DILLON (ASSISTANT SECRETARY)
(502) 596-7220
Entity
Organization
Contact information
Practice address
365 E NORTH AVE, NORTHLAKE, IL 60164
(708) 345-8100
(708) 345-0470
Mailing address
365 E NORTH AVE, NORTHLAKE, IL 60164-2628
(708) 345-8100
(708) 345-0470
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
0004952
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106
BLUE CROSS
IL
Enumeration date
10/25/2006
Last updated
05/06/2019
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