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17400 S Kedzie Ave LLC

Assisted Living Facility in Hazel Crest, IL · enumerated 2024 · authorized official Ashley Peterson, Vice President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1578321311

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Registry record

Entity type Organization (Type 2)
Legal business name 17400 S Kedzie Ave LLC
Other name <Unavail>
Practice address 17400 Kedzie Ave, Hazel Crest, IL, 60429
Phone (618) 780-3256
Enumeration date Mar 7, 2024
Last updated in NPPES May 17, 2024

Taxonomy & classification

310400000X Assisted Living Facility Nursing & Custodial Care Facilities Primary
311500000X Alzheimer Center (Dementia Center) Nursing & Custodial Care Facilities Secondary

Authorized official

Name Ashley Peterson
Title Vice President
Phone (813) 415-7589

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2024-05-17. Verify at npiregistry.cms.hhs.gov.
Where is 17400 S Kedzie Ave LLC located?
The practice location on file with NPPES is in Hazel Crest, IL.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-05-17.