Organization
CARBONDALE REHABILITATION AND NURSING CENTER II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN BLISKO (MEMBER)
(708) 236-0000
Entity
Organization
Contact information
Practice address
500 S LEWIS LN, CARBONDALE, IL 62901-3448
(618) 529-5355
Mailing address
8707 SKOKIE BLVD, SKOKIE, IL 60077-2269
(708) 236-0000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0046920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046920
FACILITY LICENSE NUMBER
IL
Enumeration date
07/07/2005
Last updated
01/27/2015
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