Hyde Park Village Nursing & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HYDE PARK VILLAGE NURSING & REHABILITATION CENTER LLC

Practice address

4505 S Drexel Blvd
Chicago, IL 60653-4301

Phone

(312) 791-0035

NPI assigned

Oct 18, 2021

Last updated

Oct 18, 2021By 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

David Mashiach

Title

Member

Phone

(312) 791-0035

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1407519333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 S DREXEL BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534301",
            "telephone_number": "312-791-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S DREXEL BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534301",
            "telephone_number": "312-791-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK VILLAGE NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "MASHIACH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "312-791-0035"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "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 Oct 18, 2021; 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.