Organization
ST AGNES MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J O'BRIEN (VICE PRESIDENT)
(312) 787-9400
Entity
Organization
Contact information
Practice address
1725 S WABASH AVE, CHICAGO, IL 60616-1219
(312) 922-2777
(312) 939-1820
Mailing address
1541 N WELLS ST, CHICAGO, IL 60610-1307
(312) 787-9400
(312) 787-9434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0027870
IL
Other
Enumeration date
01/30/2006
Last updated
08/22/2020
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