Organization
IGNITE MEDICAL HANOVER PARK, LLC
Active
Other names
Ignite Medical Hanover Park, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY FIELDS (MANAGER)
(833) 944-6483
Entity
Organization
Contact information
Practice address
2000 W LAKE ST, HANOVER PARK, IL 60133-4302
(630) 556-2000
Mailing address
1550 N NORTHWEST HWY STE 430, PARK RIDGE, IL 60068-1461
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
11/06/2023
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