Healthcare Provider Details

I. General information

NPI: 1912806571
Provider Name (Legal Business Name): THE KEYSTONE OF SPRINGFIELD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W WASHINGTON ST
SPRINGFIELD IL
62711-7917
US

IV. Provider business mailing address

3701 W LUNT AVE
LINCOLNWOOD IL
60712-2615
US

V. Phone/Fax

Practice location:
  • Phone: 217-787-9600
  • Fax: 217-787-9601
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