Adventist Midwest Geriatrics Specialists

Organization Active NPI Skilled Nursing Facility · La Grange, IL

NPI 1063789360 · NPPES record last updated Nov 30, 2011

Key facts

NPI
1063789360
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
ADVENTIST MIDWEST GERIATRICS SPECIALISTS
Practice address
5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone
(708) 245-4073
NPI assigned
Nov 30, 2011
Organization subpart
No

Authorized official

Name
Marie Rose Carcellar, APN
Title
Nurse Practitioner
Phone
(708) 245-4073

Corporate family (same tax ID) 10

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Osteopathic Physician a (11 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

5101 Willow Springs Rd
La Grange, IL 60525-2600

Mailing address

5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-4073

Other providers in La Grange, IL

All providers in La Grange, IL · Skilled Nursing Facility in Illinois

Sources for this page

Verify at the official NPI Registry.