Organization
CHICAGOLAND CHRISTIAN VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN MCGHEE (CONTROLLER)
(217) 732-5175
Entity
Organization
Contact information
Practice address
6685 E 117TH AVE, CROWN POINT, IN 46307-7808
(219) 662-0642
(219) 663-4260
Mailing address
6685 E 117TH AVE, CROWN POINT, IN 46307-7808
(219) 662-0642
(219) 663-4260
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000272904
ANTHEM BC/BS PROVIDER NUM
IN
Enumeration date
07/18/2006
Last updated
11/29/2007
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