Presence Senior Services Chicagoland

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044768 Issued in IL

Legal business name

PRESENCE SENIOR SERVICES CHICAGOLAND

Doing business as

Presence Maryhaven Nursing and Rehabilitation Center

Practice address

1700 East Lake Ave
Glenview, IL 60025

Phone

(847) 729-1300

Fax

(847) 729-9620

NPI assigned

Sep 1, 2005

Organization subpart

No

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

Authorized official

Name

Michael Gordon

Title

Cfo

Phone

(708) 478-7911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Presence Maryhaven Nursing and Rehabilitation Center Doing business as

Member of 1

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

• Presence Chicago Hospitals Network

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1194404251

  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": "1464048000000",
    "number": "1225022510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E LAKE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252003",
            "telephone_number": "847-729-1300",
            "fax_number": "847-729-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EAST LAKE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60025",
            "telephone_number": "847-729-1300",
            "fax_number": "847-729-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE SENIOR SERVICES CHICAGOLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "708-478-7911"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence Maryhaven Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Glenview, IL
• Providers in Glenview, 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 May 24, 2016; 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.