Organization
PRESBYTERIAN HOMES OUTPATIENT REHABILITATION AGENCY LLC
Active
Parent organization
PRESBYTERIAN HOMES MANAGER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRESBYTERIAN HOMES MANAGER LLC
Authorized official
MARK HAVRILKA (CHIEF FINANCIAL OFFICER)
(847) 979-3904
Entity
Organization
Contact information
Practice address
3200 GRANT ST, EVANSTON, IL 60201-1903
(847) 492-2940
(847) 492-2850
Mailing address
8707 SKOKIE BLVD STE 400, SKOKIE, IL 60077-2283
(847) 979-3955
(847) 979-3969
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
IL
Other
Enumeration date
11/28/2014
Last updated
10/08/2021
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