Provider Demographics
NPI:1689841439
Name:AURORA MANOR INC
Entity Type:Organization
Organization Name:AURORA MANOR INC
Other - Org Name:AURORA REHABILITATION AND LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-377-2400
Mailing Address - Street 1:1601 N FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1509
Mailing Address - Country:US
Mailing Address - Phone:630-898-1180
Mailing Address - Fax:630-898-1208
Practice Address - Street 1:1601 N FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1509
Practice Address - Country:US
Practice Address - Phone:630-898-1180
Practice Address - Fax:630-898-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0040097314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========801Medicaid
145006Medicare Oscar/Certification