14D2225873 CLIA NUMBER - ILLINOIS VETERANS HOME AT CHICAGO

Laboratory Demographics

CLIA Number: 14D2225873

Facility Name: ILLINOIS VETERANS HOME AT CHICAGO

Facility Address:
4250 N OAK PARK AVE
CHICAGO, IL
ZIP 60634
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Facility Phone Number: 773 794-3763

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1891367330

Taxonomy: 320700000X - Residential Treatment Facility, Physical Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	14D2225873
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	ILLINOIS VETERANS HOME AT CHICAGO
Street	4250 N OAK PARK AVE
City	CHICAGO
State	IL
ZIP	60634
Phone	773 794-3763
CertificateType	4
CertificateEffectiveDate	5/25/2023
CertificateExpirationDate	5/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024