Lake Forest Place, LLC
NPI #1336504117 in Lake Forest, Illinois
Provider Information
- NPI Number
- 1336504117
- Entity Type
- Organization
- Organization Name
- Lake Forest Place, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 22, 2015
- Last Updated
- Oct 8, 2021
Practice Location
- Address
- 1100 PEMBRIDGE DR
- City
- Lake Forest
- State
- Illinois
- ZIP Code
- 60045-4228
- Phone
- (847) 604-6700
Authorized Official
- Name
- MARK HAVRILKA
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (847) 979-3904
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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