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General NPI Number Information
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NPI Number | 1730173048
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Entity Type | Organization
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Legal Business Name | PRESENCE SENIOR SERVICES CHICAGOLAND
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1001 N GREENWOOD AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-2054
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Country | US
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Telephone | 847-692-5600
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Fax | 847-692-2305
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Provider Business Mailing Address
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Address Line | 18927 HICKORY CREEK DR SUITE #300
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City | MOKENA
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State | IL
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Zip | 60448-8590
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Country | US
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Telephone | 708-478-6382
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Fax | 708-478-6387
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Authorized Official
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Title or Position | COO
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Name | KELLIE GRONEFELD
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Credential |
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Telephone | 314-729-3500
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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 | 0044362
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License Number State | IL
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