Provider Demographics
NPI:1568533396
Name:CLAREMONT EXTENDED HEALTHCARE,LLC
Entity Type:Organization
Organization Name:CLAREMONT EXTENDED HEALTHCARE,LLC
Other - Org Name:CLAREMONT REHAB & LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-745-6240
Mailing Address - Street 1:7257 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1810
Mailing Address - Country:US
Mailing Address - Phone:847-933-2600
Mailing Address - Fax:847-933-0686
Practice Address - Street 1:150 N. WEILAND RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-7047
Practice Address - Country:US
Practice Address - Phone:847-465-0200
Practice Address - Fax:847-465-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL314000000X, 332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL145819Medicare Oscar/Certification
IL145819Medicare PIN
IL=========001Medicaid