Provider Demographics
NPI:1336191147
Name:SHERMAN WEST COURT
Entity Type:Organization
Organization Name:SHERMAN WEST COURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-742-7070
Mailing Address - Street 1:1950 LARKIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5843
Mailing Address - Country:US
Mailing Address - Phone:847-742-7070
Mailing Address - Fax:847-742-7248
Practice Address - Street 1:1950 LARKIN AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5843
Practice Address - Country:US
Practice Address - Phone:847-742-7070
Practice Address - Fax:847-742-7248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0037507314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL955OtherBLUE CROSS AND BLUE SHIEL
IL0037507OtherIDPH LICENSE
IL0037507OtherIDPH LICENSE
IL=========001Medicaid