Organization
ESTATES OF HYDE PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA DAVID LEGUM (MEMBER)
(516) 410-5209
Entity
Organization
Contact information
Practice address
4505 S DREXEL BLVD, CHICAGO, IL 60653-4301
(773) 285-0550
Mailing address
1406 WESTCHESTER RD, BUFFALO GROVE, IL 60089-6880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/20/2014
Last updated
09/30/2015
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