NPI | 1063479160 |
---|---|
Entity Type | Organization |
Authorized Contact | EARL E VAN DUSEN Administrator 708-636-7000 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0038091) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2009-02-27 |