Provider Demographics
NPI:1851942585
Name:PLAZA NURSING AND REHAB CENTER LLC
Entity Type:Organization
Organization Name:PLAZA NURSING AND REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYSTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-262-3800
Mailing Address - Street 1:4655 W CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1605
Mailing Address - Country:US
Mailing Address - Phone:847-262-3800
Mailing Address - Fax:
Practice Address - Street 1:3249 147TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3656
Practice Address - Country:US
Practice Address - Phone:708-389-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies