SKOKIE MEADOWS LLC NPI 1366081341

NPI Information

NPI: 1366081341
Provider Name: SKOKIE MEADOWS LLC

Doing Business As: SKOKIE MEADOWS

Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Organization

Address:
4600 GOLF RD
SKOKIE, IL
ZIP 60076
Phone: (847) 679-1157
Get Directions

SKOKIE MEADOWS LLC is an intermediate care facility mental illness in Skokie, IL. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. SKOKIE MEADOWS LLC NPI is 1366081341. The provider is registered as an organization entity type.
The provider Is Doing Business As Skokie Meadows.

The provider's business location address is:

4600 GOLF RD
SKOKIE, IL
ZIP 60076-210
Phone: (847) 679-1157
Fax: (847) 626-0432

The provider's authorized official is Marcella Graf .
The authorized official title is Cfo and has the following contact phone number (224) 470-2044.

The CLIA number assigned to this NPI record is 14D0882844 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/23/2019 and was last updated on 10/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310500000X	Intermediate Care Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0054312	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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