Healthcare Provider Details

I. General information

NPI: 1386364487
Provider Name (Legal Business Name): WHITEHALL SKILLED NURSING FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WAUKEGAN RD
DEERFIELD IL
60015-4908
US

IV. Provider business mailing address

3450 OAKTON ST
SKOKIE IL
60076-2951
US

V. Phone/Fax

Practice location:
  • Phone: 847-580-8287
  • Fax: 847-317-0350
Mailing address:
  • Phone: 773-844-8880
  • Fax:

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: CHAIM RAJCHENBACH
Title or Position: CEO
Credential:
Phone: 847-679-9797