Provider Demographics
NPI:1164839239
Name:SUNRISE NURSING & REHABILITATION CENTER
Entity Type:Organization
Organization Name:SUNRISE NURSING & REHABILITATION CENTER
Other - Org Name:SUNRISE NURSING & REHABILITATION CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ARYEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-440-2233
Mailing Address - Street 1:7383 N LINCOLN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1734
Mailing Address - Country:US
Mailing Address - Phone:847-440-2233
Mailing Address - Fax:847-430-5283
Practice Address - Street 1:7383 N LINCON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712
Practice Address - Country:US
Practice Address - Phone:847-440-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138089314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility