Provider Demographics
NPI:1437100021
Name:WINFIELD WOODS LLC
Entity Type:Organization
Organization Name:WINFIELD WOODS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-668-9696
Mailing Address - Street 1:28W141 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1955
Mailing Address - Country:US
Mailing Address - Phone:630-668-9696
Mailing Address - Fax:630-668-7078
Practice Address - Street 1:28W141 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1955
Practice Address - Country:US
Practice Address - Phone:630-668-9696
Practice Address - Fax:630-668-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL364103122001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL364103122001Medicaid