Healthcare Provider Details

I. General information

NPI: 1699598177
Provider Name (Legal Business Name): EFFINGHAM HEALTHCARE & SENIOR LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 N LAKEWOOD DR
EFFINGHAM IL
62401-1866
US

IV. Provider business mailing address

8153 LAWNDALE AVE
SKOKIE IL
60076-3321
US

V. Phone/Fax

Practice location:
  • Phone: 217-347-7781
  • Fax:
Mailing address:
  • Phone:
  • 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: KEVIN CHANKIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 773-745-1107