Organization
JACKSON SQUARE SKILLED NURSING AAND LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REUVEN LEVITIN (PATIENT ACCOUNTS MANAGER)
(847) 745-6240
Entity
Organization
Contact information
Practice address
5130 W JACKSON BLVD, CHICAGO, IL 60644-4332
(773) 921-8000
(773) 921-3980
Mailing address
7257 N LINCOLN AVE, LINCOLNWOOD, IL 60712-1810
(847) 933-2600
(847) 933-2601
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0039834
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740351972
NPI
—
Enumeration date
06/22/2009
Last updated
06/22/2009
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