Provider Demographics
NPI:1720439110
Name:THE LOFT REHABILITATION AND NURSING LLC
Entity Type:Organization
Organization Name:THE LOFT REHABILITATION AND NURSING LLC
Other - Org Name:SELECT POST ACUTE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-814-2000
Mailing Address - Street 1:700 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:IL
Mailing Address - Zip Code:61530-1085
Mailing Address - Country:US
Mailing Address - Phone:309-467-2337
Mailing Address - Fax:309-467-9011
Practice Address - Street 1:700 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:IL
Practice Address - Zip Code:61530-1085
Practice Address - Country:US
Practice Address - Phone:309-467-2337
Practice Address - Fax:309-467-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145431Medicare PIN