Basic Information
Provider Information
NPI: 1467445346
EntityType: 2
ReplacementNPI:  
OrganizationName: ATRIUM HEALTH CARE CENTER LTD
LastName:  
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Credential:  
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Mailing Information
Address1: 3737 W ARTHUR AVE
Address2:  
City: LINCOLNWOOD
State: IL
PostalCode: 607124029
CountryCode: US
TelephoneNumber: 8476792121
FaxNumber: 8476792122
Practice Location
Address1: 1425 W ESTES AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606262625
CountryCode: US
TelephoneNumber: 7739734780
FaxNumber: 7739731895
Other Information
ProviderEnumerationDate: 08/25/2005
LastUpdateDate: 10/05/2011
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: WEBSTER
AuthorizedOfficialFirstName: JEFFREY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 8476792121
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X0033977ILY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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