Provider Demographics
NPI:1295867208
Name:BRIAR PLACE, LTD.
Entity Type:Organization
Organization Name:BRIAR PLACE, LTD.
Other - Org Name:BRIAR PLACE
Other - Org Type:Doing Business As
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 1:6800 JOLIET RD
Mailing Address - Street 2:
Mailing Address - City:INDIANHEAD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60525-4460
Mailing Address - Country:US
Mailing Address - Phone:708-246-8500
Mailing Address - Fax:708-246-0086
Practice Address - Street 1:6800 JOLIET RD
Practice Address - Street 2:
Practice Address - City:INDIANHEAD PARK
Practice Address - State:IL
Practice Address - Zip Code:60525-4460
Practice Address - Country:US
Practice Address - Phone:708-246-8500
Practice Address - Fax:708-246-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0031765313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1132OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid
IL1132OtherBLUE CROSS BLUE SHIELD