Provider Demographics
NPI:1386364487
Name:WHITEHALL SKILLED NURSING FACILITY LLC
Entity type:Organization
Organization Name:WHITEHALL SKILLED NURSING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-679-9797
Mailing Address - Street 1:3450 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2951
Mailing Address - Country:US
Mailing Address - Phone:773-844-8880
Mailing Address - Fax:
Practice Address - Street 1:300 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4908
Practice Address - Country:US
Practice Address - Phone:847-580-8287
Practice Address - Fax:847-317-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility