Healthcare Provider Details

I. General information

NPI: 1740608736
Provider Name (Legal Business Name): ST JAMES WELLNESS REHAB AND VILLAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 E RICHTON RD
CRETE IL
60417-1623
US

IV. Provider business mailing address

2201 MAIN ST
EVANSTON IL
60202-1519
US

V. Phone/Fax

Practice location:
  • Phone: 708-672-6700
  • Fax: 708-672-4939
Mailing address:
  • Phone: 847-905-4000
  • Fax: 847-905-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LEVI ISRAEL
Title or Position: CEO
Credential:
Phone: 847-905-4000