Wood Glen Pavilion, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0043935 Issued in IL

Legal business name

WOOD GLEN PAVILION, LLC

Practice address

7444 Long Ave
Skokie, IL 60077-3214

Phone

(847) 329-4100

NPI assigned

May 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ben Klein

Title

Manager

Phone

(847) 329-4100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508074667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W NORTH AVE",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856224",
            "telephone_number": "630-876-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7444 LONG AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773214",
            "telephone_number": "847-329-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD GLEN PAVILION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-329-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0043935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Ellis Wolf, DDS
• Jeffrey Lee Wolfgang, PHARMD
• Regina Sokaler Wolgel, OTR/L
• Colin Noboru Mui Wong, ATC
• Susan Tal Wonsover, M.A. CCC SLP
• Honore Woodside, DDS
• Wound Care at Home LLC
• Melaunie Wright
• Amy Yi-Shiuan Wu, LMFT
• Dickson Wu

• Skilled Nursing Facility in Skokie, IL
• Providers in Skokie, 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.