Organization
GENERATIONS AT APPLEWOOD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WINTER (CFO)
(847) 675-7979
Entity
Organization
Contact information
Practice address
21020 KOSTNER AVE, MATTESON, IL 60443-2068
(708) 747-1300
(708) 747-8540
Mailing address
21020 KOSTNER AVE, MATTESON, IL 60443-2068
(708) 747-1300
(708) 747-8540
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0046151
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50215
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/12/2007
Last updated
08/03/2022
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