Provider Demographics
NPI:1164560363
Name:EXCEPTIONAL CARE, LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL CARE, LLC
Other - Org Name:APERION CARE BURBANK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANANGER
Authorized Official - Prefix:
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYSTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-509-0027
Mailing Address - Street 1:5701 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1332
Mailing Address - Country:US
Mailing Address - Phone:708-499-5400
Mailing Address - Fax:708-499-5472
Practice Address - Street 1:5701 W 79TH ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-1332
Practice Address - Country:US
Practice Address - Phone:708-499-5400
Practice Address - Fax:708-499-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0048496314000000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid