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Organization

PROVIDENCE OPERATIONS, LLC

Active
Other names
Providence Downers Grove
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JOHANNA R ZANDSTRA (COMPLIANCE OFFICER)
(708) 342-8137
Entity
Organization

Contact information

Practice address
3450 SARATOGA AVE, DOWNERS GROVE, IL 60515-1141
(630) 969-2900
(630) 969-2900
Mailing address
18601 NORTH CREEK DRIVE, TINLEY PARK, IL 60477
(708) 342-8100
(708) 342-8006

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0028605
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
362382853003
IL
Enumeration date
06/01/2005
Last updated
08/13/2015
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