Organization
PRESENCE SENIOR SERVICES CHICAGOLAND
Active
Other names
Ascension Living Casa Scalabrini Village
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE GRONEFELD (COO)
(314) 729-3500
Entity
Organization
Contact information
Practice address
480 N WOLF RD, NORTH LAKE, IL 60164
(708) 562-0040
(708) 562-5180
Mailing address
480 N WOLF RD, NORTHLAKE, IL 60164-1650
(708) 562-0040
(708) 562-6623
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0044792
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1201
BLUE CROSS
—
Enumeration date
09/01/2005
Last updated
07/22/2024
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