Evergreen Healthcare Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EVERGREEN HEALTHCARE CENTER, LLC

Practice address

10124 S Kedzie Ave
Evergreen Park, IL 60805-3738

Phone

(708) 907-7000

Fax

(708) 907-7003

NPI assigned

Nov 8, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Neele E. Stearns

Title

Chairman

Phone

(847) 720-8720

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Healthcare Center Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1023099819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHAFER CT",
            "address_2": "SUITE 600",
            "city": "ROSEMONT",
            "state": "IL",
            "postal_code": "600184914",
            "telephone_number": "847-720-8722",
            "fax_number": "847-720-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10124 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053738",
            "telephone_number": "708-907-7000",
            "fax_number": "708-907-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HEALTHCARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "STEARNS",
        "authorized_official_first_name": "NEELE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "847-720-8720",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Healthcare Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Skilled Nursing Facility in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.