Organization
VILLAGE NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BRANDMAN (SECRETARY AND TRESURE)
(773) 338-4400
Entity
Organization
Contact information
Practice address
9000 LAVERGNE AVE, SKOKIE, IL 60077-1618
(847) 679-2322
Mailing address
9000 LAVERGNE AVE, SKOKIE, IL 60077-1618
(847) 679-2322
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0022608
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50367
BLUECROSSBS PROVIDER NR.
IL
Enumeration date
06/30/2006
Last updated
08/22/2020
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