Provider Demographics
NPI:1215184759
Name:BRENTWOOD NORTH HEALTHCARE AND REHABILITATION CENTRE, INC.
Entity Type:Organization
Organization Name:BRENTWOOD NORTH HEALTHCARE AND REHABILITATION CENTRE, INC.
Other - Org Name:BRENTWOOD NORTH HEALTHCARE AND REHABILITATION CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-207-6468
Mailing Address - Street 1:3705 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3540
Mailing Address - Country:US
Mailing Address - Phone:847-947-9000
Mailing Address - Fax:
Practice Address - Street 1:3705 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3540
Practice Address - Country:US
Practice Address - Phone:847-947-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-5304Medicare UPIN