BALMORAL HOME INC
Skilled Nursing Facility
Chicago, Illinois
Provider NPI: 1730183203
Organization Information:Organization Name: BALMORAL HOME INC
Practice Location:
2055 W BALMORAL AVE CHICAGO, IL 60625 US
Tel: 773-561-8661 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2055 W BALMORAL AVE CHICAGO, IL 60625 US
Tel: 773-561-8661 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | IL | 000039966 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUECROSS BLUESHIELD | 1012 | IL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin