Provider Demographics
NPI:1881622264
Name:SHARON HEALTH CARE ELMS, INC.
Entity type:Organization
Organization Name:SHARON HEALTH CARE ELMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SHLOFROCK-ZUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-441-8200
Mailing Address - Street 1:465 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3045
Mailing Address - Country:US
Mailing Address - Phone:847-441-8200
Mailing Address - Fax:847-441-0800
Practice Address - Street 1:3611 N ROCHELLE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-1038
Practice Address - Country:US
Practice Address - Phone:309-688-4412
Practice Address - Fax:309-688-4480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1734162314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL1215630001Medicare NSC
146098Medicare ID - Type Unspecified