Provider Demographics
NPI:1689754814
Name:FRANKFORT TERRACE OPERATOR LLC
Entity Type:Organization
Organization Name:FRANKFORT TERRACE OPERATOR LLC
Other - Org Name:FRANKFORT TERRACE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:AVRUM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-674-5795
Mailing Address - Street 1:6865 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-4611
Mailing Address - Country:US
Mailing Address - Phone:847-674-5795
Mailing Address - Fax:847-674-5794
Practice Address - Street 1:40 SMITH ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1474
Practice Address - Country:US
Practice Address - Phone:815-469-3156
Practice Address - Fax:815-469-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0022889313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL362883294001Medicaid