Provider Demographics
NPI:1497027882
Name:OAKRIDGE HEALTHCARE CENTER LLC
Entity type:Organization
Organization Name:OAKRIDGE HEALTHCARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-812-3648
Mailing Address - Street 1:323 OAK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2019
Mailing Address - Country:US
Mailing Address - Phone:708-547-6595
Mailing Address - Fax:708-547-1971
Practice Address - Street 1:323 OAK RIDGE AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2019
Practice Address - Country:US
Practice Address - Phone:708-547-6595
Practice Address - Fax:708-547-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51862313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145996Medicare Oscar/Certification