17400 S Kedzie Ave LLC
NPI 1578321311 · Assisted Living Facility · Hazel Crest, IL
17400 S Kedzie Ave LLC is a Assisted Living Facility organization in Hazel Crest, IL (NPI 1578321311).
Provider details
- NPI number
- 1578321311
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Ashley Peterson, Vice President(813) 415-7589
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Alzheimer Center (Dementia Center)311500000X
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Waterford Estates
- Doing business as
- Waterford Estates
Registry dates
- Enumerated
- 2024-03-07
- Last updated
- 2024-05-17
- Certified
- 2024-05-17
Frequently asked questions
- What is 17400 S Kedzie Ave LLC's NPI number?
- 17400 S Kedzie Ave LLC's National Provider Identifier (NPI) is 1578321311, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 17400 S Kedzie Ave LLC?
- 17400 S Kedzie Ave LLC is classified in the NPPES registry as Assisted Living Facility (Nursing & Custodial Care Facilities).
- Where is 17400 S Kedzie Ave LLC located?
- 17400 S Kedzie Ave LLC's practice location on file with NPPES is 17400 Kedzie Ave, Hazel Crest, IL 60429-1600.
- What is 17400 S Kedzie Ave LLC's phone number?
- The practice phone number listed in the NPPES registry for 17400 S Kedzie Ave LLC is (618) 780-3256.
- Who is the authorized official for 17400 S Kedzie Ave LLC?
- The authorized official listed on 17400 S Kedzie Ave LLC's NPPES record is Ashley Peterson, Vice President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 17400 S Kedzie Ave LLC's NPI active?
- Yes — 17400 S Kedzie Ave LLC's NPI (1578321311) is active in the NPPES registry as of the last update on 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.