| NPI | 1124173844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA L LOPEZ Administrator 815-633-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0047209) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-10-26 |