CC Lake LLC

Skilled Nursing Facility · Glenview, IL

Organization Active NPI

NPI number 1649220906

Practice location

2401 Indigo Ln
Glenview, IL 60026-1299
Phone
(847) 904-4710
Fax
(847) 904-4705

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NPI record

NPI
1649220906
Entity type
Organization (Type 2)
Enumeration date
May 10, 2006
Last updated
June 1, 2026
Certified
June 1, 2026
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 1705143 IL

Mailing address

233 S Wacker Dr Ste 8400
Chicago, IL 60606-6316
Phone
(312) 803-8520

Authorized official

Name
Tomek J Koszylko
Title
Counsel
Phone
(312) 803-8443

Other names

  • Vi at The Glen
  • Vi at The Glen

About CC Lake LLC

CC Lake LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 2401 Indigo Ln, Glenview, IL 60026-1299. The NPI number 1649220906 was assigned on May 10, 2006 and the record was last updated on June 1, 2026.

CC Lake LLC lists a license in the registry: #1705143 (IL) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Tomek J Koszylko, Counsel.

Frequently asked questions

What is the NPI number of CC Lake LLC?

The NPI number is 1649220906.

What is the phone number of CC Lake LLC?

The phone number listed for the practice location is (847) 904-4710.

Where is CC Lake LLC located?

2401 Indigo Ln, Glenview, IL 60026-1299.

What is the taxonomy code for CC Lake LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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