| NPI | 1215934104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN P MILLER Member 312-994-2306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0046268) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2021-06-04 |