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Contact Information

GAF/LAKE COOK TERRACE
263 SKOKIE BLVD
NORTHBROOK, IL60062-1611
 Phone: 847-564-0505
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Custodial Care Facility

311Z00000X
Indicates primary specialty

NPI Profile & details for GAF/LAKE COOK TERRACE

NPI # 1659368264
LBN Legal business name GAF/LAKE COOK TERRACE
Authorized official MELODY GOODMAN - (MDS COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/29/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
IL Medicaid 3639624779001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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