Organization
ELISABETH LUDEMAN CENTER
Active
Other names
House 35
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJANI PATWARI M.D. (MEDICAL DIRECTOR)
(708) 283-3011
Entity
Organization
Contact information
Practice address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Mailing address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000950335001
—
IL
Enumeration date
05/07/2007
Last updated
08/22/2020
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