Organization
PRESENCE SENIOR SERVICES CHICAGOLAND
Active
Other names
Presence Maryhaven Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GORDON (CFO)
(708) 478-7911
Entity
Organization
Contact information
Practice address
1700 EAST LAKE AVE, GLENVIEW, IL 60025
(847) 729-1300
(847) 729-9620
Mailing address
1700 E LAKE AVE, GLENVIEW, IL 60025-2003
(847) 729-1300
(847) 729-9620
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0044768
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50038
BLUE CROSS
—
Enumeration date
09/01/2005
Last updated
05/24/2016
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