Healthcare Provider Details
I. General information
NPI: 1467293480
Provider Name (Legal Business Name): CITADEL AT SAINT BENEDICT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2024
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6930 W TOUHY AVE
NILES IL
60714-4522
US
IV. Provider business mailing address
3701 W LUNT AVE
LINCOLNWOOD IL
60712-2615
US
V. Phone/Fax
- Phone: 847-647-0003
- Fax: 847-647-1936
- Phone: 224-470-2044
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARCELLA
GRAF
Title or Position: CFO
Credential:
Phone: 224-470-2044