Presidential Pavilion,LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0045526 Issued in IL

Legal business name

PRESIDENTIAL PAVILION,LLC

Practice address

8001 S Western Ave
Chicago, IL 60620-5930

Phone

(773) 436-6600

Fax

(773) 471-1661

NPI assigned

Mar 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Avrum Weinfeld

Title

Ceo

Phone

(847) 674-5795

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184693152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205930",
            "telephone_number": "773-436-6600",
            "fax_number": "773-471-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205930",
            "telephone_number": "773-436-6600",
            "fax_number": "773-471-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENTIAL PAVILION,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINFELD",
        "authorized_official_first_name": "AVRUM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-674-5795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0045526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, 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 Aug 22, 2020; 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.