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NPI Code Detail

MEDICARE: HAVEN OF HILLTOP, LLC

MEDICARE: HAVEN OF HILLTOP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1427937911
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAVEN OF HILLTOP, LLC
Provider Business Mailing Address
First Line : 2201 MAIN ST
Second Line :
City : EVANSTON
State : IL
Zip : 60202-1519
Country : US
Telephone Number : 773-905-3000
Fax Number :
Provider Business Practice Location Address
First Line : 910 W POLK AVE
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-1707
Country : US
Telephone Number : 217-345-7066
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. LEVI ISRAEL
Credential :
Telephone Number : 847-905-3283
Provider Enumeration Date : 08/28/2025
Last Update Date : 08/28/2025

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