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CORTLAND MANOR LLC NPI 1487803938


NPI Information

NPI: 1487803938
Provider Name: CORTLAND MANOR LLC

Other Name: BISHOP EDWIN CONWAY RESIDENCE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1900 N. KARLOV AVE.
CHICAGO, IL
ZIP 60639
Phone: (773) 252-9941
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CORTLAND MANOR LLC is an assisted living facility in Chicago, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. CORTLAND MANOR LLC NPI is 1487803938. The provider is registered as an organization entity type.
The provider Other Name Is Bishop Edwin Conway Residence.

The provider's business location address is:

1900 N. KARLOV AVE.
CHICAGO, IL
ZIP 60639
Phone: (773) 252-9941
Fax: (773) 252-9946

The provider's authorized official is William G. D.arcy .
The authorized official title is Member-cortland Manor Llc and has the following contact phone number (312) 655-7492.

The enumeration date for this NPI number is 9/9/2008 and was last updated on 9/9/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========-60639-01MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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