Lexington Health Care Center of Chicago Ridge, Inc.

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

0042739 Issued in IL

Legal business name

LEXINGTON HEALTH CARE CENTER OF CHICAGO RIDGE, INC.

Practice address

10300 Southwest Hwy
Chicago Ridge, IL 60415-1426

Phone

(708) 425-1100

Fax

(708) 425-0779

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Samatas

Title

President

Phone

(630) 458-4700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1124142278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W NORTH AVE",
            "address_2": "SUITE 500",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601481134",
            "telephone_number": "630-458-4700",
            "fax_number": "630-458-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SOUTHWEST HWY",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151426",
            "telephone_number": "708-425-1100",
            "fax_number": "708-425-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON HEALTH CARE CENTER OF CHICAGO RIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "SAMATAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-458-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "IL",
            "license": "0042739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna J Kilgallon, LCPC
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• Lexington Health Care Center of Chicago Ridge Inc
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• Parenteral & Enteral Nutrition Supplies (DME) in Chicago Ridge, IL
• Providers in Chicago Ridge, IL by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.