| NPI | 1083602031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA A CHATTIC Administrator 815-589-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0009530) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2012-10-23 |