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FULLERTON SKILLED NURSING FACILITY LLC
NPI 1972361731
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Chicago, IL

Active since March 07, 2024
1366 W FULLERTON AVE, CHICAGO, IL 60614(773) 844-8880 Get Directions Write a Review

NPPES record last updated: March 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fullerton Skilled Nursing Facility Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FULLERTON SKILLED NURSING FACILITY LLC (NPI 1972361731), doing business as Avantara Lincoln Park, is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Chicago, Illinois and active in the NPI registry since March 2024. The organization lists Menachem Shabat, President, as its authorized official.

NPPES Registry Identity

NPI1972361731
Entity TypeOrganization
Primary Taxonomy261QR0401X
Legal Business NameFULLERTON SKILLED NURSING FACILITY LLC
Location Address1366 W FULLERTON AVEChicago, IL 60614-2129
Mailing Address3450 Oakton StSkokie, IL 60076-2951 · (773) 844-8880
Phone(773) 844-8880
Organization SubpartNo
Authorized OfficialMenachem ShabatPresident · (847) 679-5331
Enumeration DateMarch 7, 2024
NPPES CertifiedMarch 7, 2024
✔ NPI 1972361731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
Taxonomy Code261QR0401X
1366 W FULLERTON AVE, Chicago, IL 60614
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Other Names 1

Doing Business AsAvantara Lincoln Park

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. GENEVIEVE MARIE D'AQUILA
Speech-Language Pathologist
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (772) 248-9300
ADRIAN LOUIS POLLARD LPTA
Physical Therapy Assistant
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
ISABELLA MUELLER
Occupational Therapist
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
YUMIN KAO
Occupational Therapist
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
COLLEEN RAMKISSOON PTA
Physical Therapy Assistant
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
MR. LUIS ANTONIO CORTEZ COTA
Occupational Therapy Assistant
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
LAURA GARZA PT
Physical Therapist
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300
LORI VANDELLEN OTR/L
Occupational Therapist
1366 W FULLERTON AVE
CHICAGO, IL 60614
Cook County (773) 248-9300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fullerton Skilled Nursing Facility LLC's NPI number?

The NPI number for Fullerton Skilled Nursing Facility LLC is 1972361731. It was assigned to this organization in the NPPES registry on March 7, 2024. The provider is doing business as Avantara Lincoln Park.

Where is Fullerton Skilled Nursing Facility LLC located?

Fullerton Skilled Nursing Facility LLC is located at 1366 W Fullerton Ave, Chicago, IL 60614. The listed phone number is (773) 844-8880.

What is Fullerton Skilled Nursing Facility LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), with taxonomy code 261QR0401X.

When was this NPI record last updated?

The NPPES record for Fullerton Skilled Nursing Facility LLC was last updated on March 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.