Organization
LONG GROVE PAC LLC
Active
Other names
AVANTARA LONG GROVE
Organization subpart
No
Provider details
NPI number
Authorized official
YAIR ZUCKERMAN (COO)
(847) 679-9797
Entity
Organization
Contact information
Practice address
1666 RFD, LONG GROVE, IL 60047-7368
(847) 419-1111
(847) 419-1119
Mailing address
7040 N RIDGEWAY AVE, LINCOLNWOOD, IL 60712-2620
(847) 679-9797
(847) 676-5348
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/31/2014
Last updated
06/30/2015
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