Provider Demographics
NPI:1386876050
Name:THE CLARE AT WATER TOWER
Entity type:Organization
Organization Name:THE CLARE AT WATER TOWER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-647-6500
Mailing Address - Street 1:55 E PEARSON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2535
Mailing Address - Country:US
Mailing Address - Phone:312-784-8000
Mailing Address - Fax:312-951-5893
Practice Address - Street 1:55 E PEARSON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2535
Practice Address - Country:US
Practice Address - Phone:312-784-8000
Practice Address - Fax:312-951-5893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0046789314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0046789OtherSTATE LICENSE
IL0046789OtherSTATE LICENSE