Organization
COUNTY OF LAKE
Active
Other names
d/b/a Winchester House
Organization subpart
No
Provider details
NPI number
Authorized official
RICK C MEESKE (FINANCE DIRECTOR)
(847) 377-7236
Entity
Organization
Contact information
Practice address
1125 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1304
(847) 377-7236
(847) 377-7205
Mailing address
1125 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1304
(847) 377-7236
(847) 377-7205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000010678
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010678
IDPH LICENSE NUMBER
IL
Enumeration date
08/04/2005
Last updated
08/13/2014
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