Organization
BELHAVEN NURSING AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY G RICHARDSON (CONTROLLER)
(773) 233-6311
Entity
Organization
Contact information
Practice address
11401 S OAKLEY AVE, CHICAGO, IL 60643-4196
(773) 233-6311
(773) 233-9304
Mailing address
11401 S OAKLEY AVE, CHICAGO, IL 60643-4196
(773) 233-6311
(773) 233-9304
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0048215
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032
BC/BS PROVIDER NUMBER
IL
01
—
50601
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
07/13/2005
Last updated
09/16/2013
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