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Organization

SYMPHONY JACKSON SQUARE LLC

Active
Other names
Jackson Square Skilled Nursing & Living Center
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HARTMAN (AUTHORIZED OFFICIAL)
(847) 745-6212
Entity
Organization

Contact information

Practice address
5130 W JACKSON BLVD, CHICAGO, IL 60644-4332
(773) 921-8000
Mailing address
7257 N LINCOLN AVE, LINCOLNWOOD, IL 60712-1810
(847) 745-6212

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14-5661
MEDICARE ID
Enumeration date
05/13/2015
Last updated
09/15/2015
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