17400 S Kedzie Ave LLC
NPI 1578321311ActiveOrganization· Assisted Living Facility· Hazel Crest, IL
Assisted Living Facility in Hazel Crest, Illinois, registered in NPPES in March 2024. The authorized official on file is Ashley Peterson, Vice President.
Overview
| NPI | 1578321311 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 7, 2024 |
| Last updated in NPPES | May 17, 2024 |
| Certified by provider | May 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
| Alzheimer Center (Dementia Center) | 311500000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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