Healthcare Provider Details

I. General information

NPI: 1326478108
Provider Name (Legal Business Name): PLEASANT MEADOWS SENIOR LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2013
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W WASHINGTON AVE
CHRISMAN IL
61924-1042
US

IV. Provider business mailing address

331 S YORK RD STE 301
BENSENVILLE IL
60106-2673
US

V. Phone/Fax

Practice location:
  • Phone: 217-269-2396
  • Fax:
Mailing address:
  • Phone: 630-217-1014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. ANNA SARAH SALAZAR DUJUA
Title or Position: DIRECTOR OF AR
Credential:
Phone: 630-217-1014