Provider Demographics
NPI:1902194905
Name:GENEVA NURSING AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:GENEVA NURSING AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-933-9200
Mailing Address - Street 1:1101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2438
Mailing Address - Country:US
Mailing Address - Phone:630-232-7544
Mailing Address - Fax:
Practice Address - Street 1:3856 OAKTON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3454
Practice Address - Country:US
Practice Address - Phone:847-933-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility