Provider Demographics
NPI:1225153539
Name:LEMONT NURSING AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:LEMONT NURSING AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-905-3000
Mailing Address - Street 1:12450 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-9301
Mailing Address - Country:US
Mailing Address - Phone:630-243-0400
Mailing Address - Fax:630-243-0563
Practice Address - Street 1:12450 WALKER RD
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9301
Practice Address - Country:US
Practice Address - Phone:630-243-0400
Practice Address - Fax:630-243-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0046201314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL50241OtherBLUE CROSS BLUE SHIELD
IL50241OtherBLUE CROSS BLUE SHIELD
IL50241OtherBLUE CROSS BLUE SHIELD