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NPI Code Detail

MEDICARE: CASEYVILLE NURSING & REHABILITATION CENTER INC.

MEDICARE: CASEYVILLE NURSING & REHABILITATION CENTER INC.
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 Facility0039644IL

General Provider Information

NPI Number : 1700850526
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASEYVILLE NURSING & REHABILITATION CENTER INC.
Provider Business Mailing Address
First Line : 3856 OAKTON ST STE 250
Second Line :
City : SKOKIE
State : IL
Zip : 60076-3454
Country : US
Telephone Number : 847-982-2300
Fax Number : 847-982-2304
Provider Business Practice Location Address
First Line : 601 W LINCOLN AVE
Second Line :
City : CASEYVILLE
State : IL
Zip : 62232-1306
Country : US
Telephone Number : 618-345-3072
Fax Number : 618-345-3170
Authorized Official
Title or Position : COMPTROLLER
Name : MOE HERMAN
Credential :
Telephone Number : 847-982-2300
Provider Enumeration Date : 02/16/2006
Last Update Date : 12/23/2024

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Practice Fax: 847-982-2304
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