Provider Demographics
NPI:1598469199
Name:CAMPBELL HEALTHCARE & SENIOR LIVING, LLC
Entity Type:Organization
Organization Name:CAMPBELL HEALTHCARE & SENIOR LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-945-1000
Mailing Address - Street 1:8131 MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17108 US HIGHWAY 62
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:MO
Practice Address - Zip Code:63933-6383
Practice Address - Country:US
Practice Address - Phone:573-246-2155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility