Healthcare Provider Details

I. General information

NPI: 1407971716
Provider Name (Legal Business Name): LAKEWOOD NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14718 S EASTERN AVE
PLAINFIELD IL
60544-8870
US

IV. Provider business mailing address

2201 MAIN ST
EVANSTON IL
60202-1519
US

V. Phone/Fax

Practice location:
  • Phone: 815-436-3400
  • Fax: 815-436-8394
Mailing address:
  • Phone: 847-905-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0046169
License Number StateIL

VIII. Authorized Official

Name: MRS. LEVI ISRAEL
Title or Position: CEO
Credential:
Phone: 847-905-3000