Provider Demographics
NPI:1598754764
Name:GENERATIONS AT NEIGHBORS LLC
Entity Type:Organization
Organization Name:GENERATIONS AT NEIGHBORS LLC
Other - Org Name:NEIGHBORS REHABILITATION CENTER LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-674-5200
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010-0585
Mailing Address - Country:US
Mailing Address - Phone:815-234-2511
Mailing Address - Fax:815-234-5168
Practice Address - Street 1:811 W 2ND ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:IL
Practice Address - Zip Code:61010-1464
Practice Address - Country:US
Practice Address - Phone:815-234-2511
Practice Address - Fax:815-234-5168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0049973314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL6298730001Medicare NSC
IL=========001Medicaid