Concord Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0026914 Issued in IL

Legal business name

CONCORD NURSING HOME, INC.

Doing business as

Concord Extended Care

Practice address

9401 Ridgeland Ave
Oak Lawn, IL 60453-2221

Phone

(708) 599-6700

Fax

(708) 599-6258

NPI assigned

Mar 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Steinberg

Title

Chief Operating Officer

Phone

(847) 905-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Concord Extended Care Doing business as

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285766204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 RIDGELAND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532221",
            "telephone_number": "708-599-6700",
            "fax_number": "708-599-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 RIDGELAND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532221",
            "telephone_number": "708-599-6700",
            "fax_number": "708-599-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEINBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "847-905-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0026914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1233",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Oak Lawn, IL
• Providers in Oak Lawn, 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.