Southshore Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0042119 Issued in IL

Legal business name

SOUTHSHORE CARE CENTER, LLC

Doing business as

South Shore Nursing & Rehab Center

Practice address

2649 E 75TH St
Chicago, IL 60649-3835

Phone

(773) 356-9300

Fax

(773) 356-9384

NPI assigned

Mar 20, 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

Mark Steinberg

Title

Chief Operatng Officer

Phone

(847) 905-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Shore Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659496966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493835",
            "telephone_number": "773-356-9300",
            "fax_number": "773-356-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493835",
            "telephone_number": "773-356-9300",
            "fax_number": "773-356-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSHORE CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEINBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF OPERATNG OFFICER",
        "authorized_official_telephone_number": "847-905-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0042119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1193",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Shore Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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.