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General NPI Number Information
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NPI Number | 1205127628
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Entity Type | Organization
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Legal Business Name | CHESTER REHABILITATION AND NURSING CENTER, LLC
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 770 STATE ST
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City | CHESTER
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State | IL
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Zip | 62233-1642
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Country | US
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Telephone | 618-826-2314
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Fax | 618-826-5047
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Provider Business Mailing Address
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Address Line | 4213 MAIN ST
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City | SKOKIE
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State | IL
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Zip | 60076-2046
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Country | US
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Telephone | 708-426-2315
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Fax | 708-236-0001
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Authorized Official
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Title or Position | A/R DIRECTOR
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Name | MRS. ANETTA KOZLOWSKA
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Credential |
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Telephone | 708-236-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0023390
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License Number State | IL
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