Organization
PRAIRIE MANOR NURSING & REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEVI ISRAEL (CEO)
(847) 905-3000
Entity
Organization
Contact information
Practice address
345 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1757
(708) 754-7601
(708) 754-5292
Mailing address
2201 MAIN ST, EVANSTON, IL 60202-1519
(847) 905-3000
(708) 754-5292
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0046011
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50244
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/20/2007
Last updated
08/11/2025
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