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General NPI Number Information
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NPI Number | 1417610163
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Entity Type | Organization
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Legal Business Name | CRESTWOOD REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 14255 CICERO AVE
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City | CRESTWOOD
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State | IL
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Zip | 60418-2154
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Country | US
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Telephone | 708-371-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 MAIN ST
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City | EVANSTON
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State | IL
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Zip | 60202-1519
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Country | US
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Telephone | 847-905-3000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. LEVI ISRAEL
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Credential |
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Telephone | 847-905-3000
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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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