| Organization Name: | LEXINGTON HEALTH CARE CENTER OF CHICAGO RIDGE, INC. |
| NPI Number: | 1124142278 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN SAMATAS (PRESIDENT) |
| Mailing Address: | 10300 Southwest Hwy Chicago Ridge |
| State: | IL US |
| Postal Code: | 604151426 |
| Phone Number: | 7084251100 |
| Fax Number: | 7084250779 |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | 0042739 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |