Provider Demographics
NPI:1952419087
Name:WEST SUBURBAN CARE CENTER, LLC
Entity Type:Organization
Organization Name:WEST SUBURBAN CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:312-207-6468
Mailing Address - Street 1:311 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1979
Mailing Address - Country:US
Mailing Address - Phone:630-894-7400
Mailing Address - Fax:630-894-8528
Practice Address - Street 1:311 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1979
Practice Address - Country:US
Practice Address - Phone:630-894-7400
Practice Address - Fax:630-894-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
14-5333Medicare ID - Type Unspecified