Imperial of Hazelcrest

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0040402 Issued in IL

Legal business name

IMPERIAL OF HAZELCREST

Practice address

8320 Skokie Blvd
Skokie, IL 60077-2545

Phone

(847) 329-1555

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Jennie Shan-Martin

Title

Cfo

Phone

(847) 329-1555

Specialties & licenses 1

Addresses

Other names 1

• careplus management Other name

Tax ID family

Careplus Management2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Imperial of Hazel Crest

  • Skilled Nursing Facility
  • Hazel Crest, IL
  • NPI 1376744250
  NPD tax ID

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689884629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772545",
            "telephone_number": "847-329-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772545",
            "telephone_number": "847-329-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL OF HAZELCREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAN-MARTIN",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-329-1555"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0040402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "careplus management",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Avinash Inabathula, MD
• Leslie Joseph Inch, LCSW
• Infinite Home Health Care Inc.

• 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.