Provider Demographics
NPI:1770039075
Name:ALDEN COURTS OF SHOREWOOD, INC.
Entity Type:Organization
Organization Name:ALDEN COURTS OF SHOREWOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT RECEIVABLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVELINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-724-6376
Mailing Address - Street 1:700 W. BLACK RD.
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-8400
Mailing Address - Country:US
Mailing Address - Phone:815-230-8700
Mailing Address - Fax:
Practice Address - Street 1:4200 W. PETERSON AVE.
Practice Address - Street 2:SUITE 140
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6074
Practice Address - Country:US
Practice Address - Phone:773-286-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility