Presence Senior Services Chicagoland

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044792 Issued in IL

Legal business name

PRESENCE SENIOR SERVICES CHICAGOLAND

Doing business as

Ascension Living Casa Scalabrini Village

Practice address

480 N Wolf Rd
North Lake, IL 60164

Phone

(708) 562-0040

Fax

(708) 562-5180

NPI assigned

Sep 1, 2005

Last updated

Jul 22, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kellie Gronefeld

Title

Coo

Phone

(314) 729-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ascension Living Casa Scalabrini Village Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Resurrection Medical Center - Chicago LLC

  dba Prime Healthcare Home Infusion Pharmacy

  • Home Infusion Therapy Pharmacy
  • Chicago, IL
  • NPI 1538823539

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1023002318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 N WOLF RD",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601641650",
            "telephone_number": "708-562-0040",
            "fax_number": "708-562-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N WOLF RD",
            "city": "NORTH LAKE",
            "state": "IL",
            "postal_code": "60164",
            "telephone_number": "708-562-0040",
            "fax_number": "708-562-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE SENIOR SERVICES CHICAGOLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "GRONEFELD",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "314-729-3500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Living Casa Scalabrini Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Piotr Pawlowski, CSA
• Ana Laura Perez, SPEECH LANGUAGE PATH
• Allison Porschakin
• Powerback Rehabilitation LLC
• Premier Care Services LLC
• Prime Care LTC Consulting Inc
• Richard David Rambo, RPH
• Recovercare, LLC
• Elizabeth Robbin, M.S., CCC-SLP/L
• Keith P. Rojek, DDS

• Skilled Nursing Facility in Northlake, IL
• Providers in Northlake, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.