Provider Demographics
NPI:1417647157
Name:PEARL OF EVANSTON, LLC
Entity type:Organization
Organization Name:PEARL OF EVANSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EITAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEFFREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-492-7700
Mailing Address - Street 1:4711 GOLF RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1236
Mailing Address - Country:US
Mailing Address - Phone:847-933-9280
Mailing Address - Fax:
Practice Address - Street 1:820 FOSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3212
Practice Address - Country:US
Practice Address - Phone:847-492-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility