Crestwood Terrace Operator LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0022863 Issued in IL

Legal business name

CRESTWOOD TERRACE OPERATOR LLC

Practice address

13301 Central Ave
Crestwood, IL 60445-1370

Phone

(708) 597-5251

Fax

(708) 597-4998

NPI assigned

Oct 6, 2006

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. Avrum Weinfeld

Title

Cfo

Phone

(847) 674-5795

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• crestwood terrace Former legal business name

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811084213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124611",
            "telephone_number": "847-674-5795",
            "fax_number": "847-674-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 CENTRAL AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451370",
            "telephone_number": "708-597-5251",
            "fax_number": "708-597-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD TERRACE OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINFELD",
        "authorized_official_first_name": "AVRUM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-674-5795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0022863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362883290001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "crestwood terrace",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Crestwood Medical Associates LTD
• Crestwood Rehabilitation Center LLC
• CT Care, LLC (Crestwood Terrace Nursing Center)
• Diana Daley, COTA
• Daniel J. Sweeney DC, LTD.
• Brittany Lee Davis, MS, CCC-SLP
• Sakeena Dean

• Nursing Facility/Intermediate Care Facility in Crestwood, IL
• Providers in Crestwood, IL by specialty
• Nursing Facility/Intermediate Care 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.