Organization
FULLERTON SKILLED NURSING FACILITY LLC
Active
Other names
Avantara Lincoln Park
Organization subpart
No
Provider details
NPI number
Authorized official
MENACHEM SHABAT (PRESIDENT)
(847) 679-5331
Entity
Organization
Contact information
Practice address
1366 W FULLERTON AVE, CHICAGO, IL 60614-2129
(773) 844-8880
Mailing address
3450 OAKTON ST, SKOKIE, IL 60076-2951
(773) 844-8880
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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