Provider Demographics
NPI:1821726738
Name:GENERATIONS AT REGENCY, LLC
Entity Type:Organization
Organization Name:GENERATIONS AT REGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
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 1:6631 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4416
Mailing Address - Country:US
Mailing Address - Phone:847-647-7444
Mailing Address - Fax:847-647-6403
Practice Address - Street 1:6631 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4416
Practice Address - Country:US
Practice Address - Phone:847-647-7444
Practice Address - Fax:847-647-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies