Provider Demographics
NPI:1114204831
Name:BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC
Entity Type:Organization
Organization Name:BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-971-2645
Mailing Address - Street 1:5801 S CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2300
Mailing Address - Country:US
Mailing Address - Phone:630-971-2645
Mailing Address - Fax:630-969-0617
Practice Address - Street 1:5801 S CASS AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2300
Practice Address - Country:US
Practice Address - Phone:630-971-2645
Practice Address - Fax:630-969-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility