Provider Demographics
NPI:1124009873
Name:FOREST HILL HEALTH & REHAB CENTER INC
Entity Type:Organization
Organization Name:FOREST HILL HEALTH & REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-279-9420
Mailing Address - Street 1:4747 11TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-4404
Mailing Address - Country:US
Mailing Address - Phone:309-796-0922
Mailing Address - Fax:
Practice Address - Street 1:4747 11TH ST
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-4404
Practice Address - Country:US
Practice Address - Phone:309-796-0922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0042309313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0042309OtherSTATE LICENSE
IL0042309OtherSTATE LICENSE