Provider Demographics
NPI:1508894981
Name:CHICAGO-BARTON, LLC
Entity Type:Organization
Organization Name:CHICAGO-BARTON, LLC
Other - Org Name:BARTON SENIOR RESIDENCES OF CHICAGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:DUROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-441-8200
Mailing Address - Street 1:465 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3045
Mailing Address - Country:US
Mailing Address - Phone:847-441-8200
Mailing Address - Fax:847-441-0800
Practice Address - Street 1:1245 S WOOD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1943
Practice Address - Country:US
Practice Address - Phone:312-421-5220
Practice Address - Fax:312-421-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid