Provider Demographics
NPI:1629504600
Name:NORTH OAK HEALTH CARE, INC.
Entity Type:Organization
Organization Name:NORTH OAK HEALTH CARE, INC.
Other - Org Name:FIELDCREST MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MASCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-612-0750
Mailing Address - Street 1:1025 SHERMER RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3730
Mailing Address - Country:US
Mailing Address - Phone:847-612-0750
Mailing Address - Fax:
Practice Address - Street 1:1510 S 30TH ST
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5902
Practice Address - Country:US
Practice Address - Phone:920-682-8980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0016554313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility