Provider Demographics
NPI:1104181015
Name:FOSTER HEALTH & REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:FOSTER HEALTH & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-919-9813
Mailing Address - Street 1:2840 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3506
Mailing Address - Country:US
Mailing Address - Phone:773-561-2040
Mailing Address - Fax:773-561-2060
Practice Address - Street 1:2840 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3506
Practice Address - Country:US
Practice Address - Phone:773-561-2040
Practice Address - Fax:773-561-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility