OrganizationActive
17400 S Kedzie Ave LLC
NPI 1578321311 · Assisted Living Facility · Hazel Crest, IL
Provider details
- NPI number
- 1578321311
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Ashley Peterson, Vice President
Mailing address
17400 Kedzie Ave
Hazel Crest, IL 60429-1600
Registry dates
- Enumerated
- 2024-03-07
- Last updated
- 2024-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.