Organization · Type 2 NPI

Rest Haven Illiana Christian Convalescent Home

Skilled Nursing Facility · South Holland, IL

NPI number 1124020474 Active

Practice location

16300 Wausau Ave
South Holland, IL 60473-2158

Fax (708) 596-5527

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	0023242 (IL)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

8 other providers at this address

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NPI record

NPI: 1124020474
Entity type: Organization (Type 2)
Issued: Jun 1, 2005
Last updated: Apr 14, 2009
Status: Active

Other names

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Providence Healthcare and Rehabilitation Center South Holland · doing business as

Authorized official

Ms. Joan C McCarthy
VP Operational Systems
(708) 342-8179

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124020474

Rest Haven Illiana Christian Convalescent Home's National Provider Identifier is 1124020474, issued on Jun 1, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in South Holland, IL. The record was last updated on Apr 14, 2009.