Provider Demographics
NPI:1407805096
Name:BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC
Entity Type:Organization
Organization Name:BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC
Other - Org Name:WESTBURY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-918-5000
Mailing Address - Street 1:1800 ROBIN LN
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2086
Mailing Address - Country:US
Mailing Address - Phone:630-810-0500
Mailing Address - Fax:
Practice Address - Street 1:1800 ROBIN LN
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2086
Practice Address - Country:US
Practice Address - Phone:630-810-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-09
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0042226314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146061Medicare Oscar/Certification