Montgomery Place

LBN: Montgomery Place
Montgomery Place is an health care organization with primary practice located at 5550 S Shore Dr , Chicago IL 60637-5051. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty. Montgomery Place can be contacted via phone (773) 753-4100, or through Hart, Deborah E via phone (773) 753-4096.

Contact Information

Primary practice address
5550 S Shore Dr Chicago IL 60637-5051
Phone: (773) 753-4100
Fax: (773) 752-0056
Website:
Map and Directions
Authorized official contact:
Name: Hart, Deborah E
Phone: (773) 753-4096

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 0037515 Illinois
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1811018112
LBN Legal business name Montgomery Place
DBA Doing business as
Authorized official Hart, Deborah E
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Mar 3rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811018112 NPPES
Other 14D0895395 CLIA WAIVER

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