Organization
WALNUT GROVE VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARAK BAVER (CFO)
(773) 202-0000
Entity
Organization
Contact information
Practice address
4055 W PETERSON AVE, SUITE 101, CHICAGO, IL 60646-6182
(773) 202-0000
(773) 267-0111
Mailing address
1095 TWILIGHT DR, MORRIS, IL 60450-3305
(815) 942-5108
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0033506
IL
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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