Healthcare Provider Details

I. General information

NPI: 1902413537
Provider Name (Legal Business Name): CITADEL OF GLENVIEW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E LAKE AVE
GLENVIEW IL
60025-2003
US

IV. Provider business mailing address

3755 CHASE AVE
SKOKIE IL
60076-4008
US

V. Phone/Fax

Practice location:
  • Phone: 847-729-1300
  • Fax: 847-729-9620
Mailing address:
  • Phone: 224-470-2044
  • Fax: 224-470-2952

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: MARCELLA GRAF
Title or Position: CFO
Credential:
Phone: 224-470-2044