Organization
RENAISSANCE AT MIDWAY INC
Active
Other names
CLARIDGE AT CICERO
Organization subpart
No
Provider details
NPI number
Authorized official
REUVEN LEVITIN (PATIENT ACCOUNTS MANAGER)
(847) 745-6240
Entity
Organization
Contact information
Practice address
4437 S CICERO AVE, CHICAGO, IL 60632-4333
(773) 884-0484
(773) 884-0485
Mailing address
7257 N LINCOLN AVE, LINCOLNWOOD, IL 60712-1810
(847) 933-2600
(847) 933-0686
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
IL
332BN1400X
Nursing Facility Supplies (DME)
5003380001
IL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
5003380001
IL
Other
Enumeration date
11/10/2006
Last updated
03/16/2009
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