Organization
LAKE SHORE HEALTHCARE & REHABILITATION CENTRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NESANEL DAVIS (ADMINISTRATOR)
(773) 463-1313
Entity
Organization
Contact information
Practice address
7200 N SHERIDAN RD, CHICAGO, IL 60626-2613
(773) 973-7200
Mailing address
3553 W PETERSON AVE, SUITE 300, CHICAGO, IL 60659-3200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/18/2009
Last updated
08/06/2010
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