Healthcare Provider Details

I. General information

NPI: 1891765996
Provider Name (Legal Business Name): PRESBYTERIAN HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 E CENTRAL RD
ARLINGTON HEIGHTS IL
60005-3244
US

IV. Provider business mailing address

811 E CENTRAL RD ATTN ACCOUNTING DEPARTMENT
ARLINGTON HEIGHTS IL
60005-3244
US

V. Phone/Fax

Practice location:
  • Phone: 847-437-6700
  • Fax: 847-956-4451
Mailing address:
  • Phone: 847-437-6700
  • Fax: 847-956-4451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0045047
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number0045047
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT B LANDSMAN
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 847-492-4859