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NPI 1336003003

NPI 1336003003 : CHARLESTON REHAB AND NURSING LLC : CHARLESTON, IL

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General NPI Number Information
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    NPI Number           |    1336003003
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHARLESTON REHAB AND NURSING LLC 
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Dates
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    Enumeration Date     |    12/16/2025
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    Last Update Date     |    12/16/2025
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Provider Practice Location Address
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    Address Line         |    716 18TH ST 
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    City                 |    CHARLESTON
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    State                |    IL
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    Zip                  |    61920-2382
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    Country              |    US
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    Telephone            |    217-345-7054
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    Fax                  |    217-348-1264
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Provider Business Mailing Address
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    Address Line         |    716 18TH ST 
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    City                 |    CHARLESTON
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    State                |    IL
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    Zip                  |    61920-2382
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    Country              |    US
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    Telephone            |    217-345-7054
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    Fax                  |    217-348-1264
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     CHAIM  MILLMAN 
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    Credential           |    DO
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    Telephone            |    845-414-3300
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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       |    
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    License Number State |    
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