# PRESBYTERIAN HOMES OUTPATIENT REHABILITATION AGENCY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRESBYTERIAN HOMES MANAGER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306243852
- **Legal business name:** PRESBYTERIAN HOMES MANAGER LLC
- **Authorized official:** MARK HAVRILKA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (847) 979-3904

## Contact information

- **Practice address:** 3200 GRANT ST, EVANSTON, IL 60201-1903
- **Practice address phone:** (847) 492-2940
- **Practice address fax:** (847) 492-2850
- **Mailing address:** 8707 SKOKIE BLVD STE 400, SKOKIE, IL 60077-2283
- **Mailing address phone:** (847) 979-3955
- **Mailing address fax:** (847) 979-3969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 11/28/2014
- **Last updated:** 10/08/2021