- Enrollment id
- O20210528000334
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952996142
- Multiple npi flag
- N
- Ccn
- 145946
- Associate id
- 8628477452
- Organization name
- PEARL OF HILLSIDE LLC
- Doing business as name
- THE PEARL OF HILLSIDE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PEARL OF HILLSIDE,THE
- Affiliation entity name
- PEARL HEALTHCARE
- Affiliation entity id
- 595
- Address line 1
- 4600 FRONTAGE RD
- City
- HILLSIDE
- State
- IL
- Zip code
- 601621703