Organization
PA PETERSON AT THE CITADEL LLC
Active
Other names
PA Peterson at the Citadel
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLA GRAF (CFO)
(224) 470-2044
Entity
Organization
Contact information
Practice address
1311 PARKVIEW AVE, ROCKFORD, IL 61107-1818
(815) 399-8832
(815) 399-8342
Mailing address
3755 CHASE AVE, SKOKIE, IL 60076-4008
(224) 470-2044
(224) 470-2952
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/31/2017
Last updated
11/04/2025
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