Organization
COUNTRYSIDE NURSING AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE ZIMMERMAN (CEO)
(847) 905-4000
Entity
Organization
Contact information
Practice address
1635 E 154TH ST, DOLTON, IL 60419-3001
(708) 841-9550
(708) 841-4517
Mailing address
1635 E 154TH ST, DOLTON, IL 60419-3001
(708) 841-9550
(708) 841-4517
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0050708
IL
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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