1821075474 NPI number — WOODBRIDGE NURSING PAVILION, LTD.

Table of content: DR. ALAN MICHAEL SILBERT MD (NPI 1558359810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821075474 NPI number — WOODBRIDGE NURSING PAVILION, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOODBRIDGE NURSING PAVILION, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821075474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3359 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SKOKIE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60076-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-679-8219
Provider Business Mailing Address Fax Number:
847-679-7377

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2242 N KEDZIE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60647-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-486-7700
Provider Business Practice Location Address Fax Number:
773-486-7937
Provider Enumeration Date:
12/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MAUER
Authorized Official First Name:
MARSHALL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
SECRETARY-TREASURER
Authorized Official Telephone Number:
847-679-8219

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  0034157 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com