Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

17400 S Kedzie Ave LLC

Organization Assisted Living Facility · NPI 1578321311

17400 S Kedzie Ave LLC is an Assisted Living Facility in Hazel Crest, Illinois. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17400 Kedzie Ave
Hazel Crest, IL 60429-1600
Phone: (618) 780-3256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Alzheimer Center (Dementia Center) Taxonomy 311500000X

Record details

NPI number1578321311
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Peterson — Vice President · (813) 415-7589
Other names Waterford Estates; Waterford Estates
NPI enumeratedMarch 7, 2024
Last updated in NPPESMay 17, 2024
Certification dateMay 17, 2024
Mailing address17400 Kedzie Ave, Hazel Crest, IL 60429-1600

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