Basic Information
| Provider Information | |||||||||
| NPI: | 1295466423 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABBINGTON VILLAGE NURSING AND REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8707 SKOKIE BLVD | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600772269 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 31 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | ROSELLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601721903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308945058 | ||||||||
| FaxNumber: | 6308945070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2022 | ||||||||
| LastUpdateDate: | 10/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | MASHIACH | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7738966723 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.