Healthcare Provider Details

I. General information

NPI: 1154756195
Provider Name (Legal Business Name): ISLAND CITY REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W KAHLER RD
WILMINGTON IL
60481-1527
US

IV. Provider business mailing address

8131 MONTICELLO AVE
SKOKIE IL
60076-3325
US

V. Phone/Fax

Practice location:
  • Phone: 815-476-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number52506
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER SPECTOR
Title or Position: VP OF REVENUE CYCLE MANAGEMENT
Credential:
Phone: 847-262-3800