Organization
CC LAKE INC
Active
Other names
Vi at the Glen
Organization subpart
No
Provider details
NPI number
Authorized official
TOMEK J KOSZYLKO (COUNSEL)
(312) 803-8443
Entity
Organization
Contact information
Practice address
2401 INDIGO LN, GLENVIEW, IL 60026-1299
(847) 904-4600
Mailing address
233 S WACKER DR STE 8400, CHICAGO, IL 60606-6316
(312) 803-8800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
10/24/2025
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