Healthcare Provider Details

I. General information

NPI: 1457362097
Provider Name (Legal Business Name): AURORA MANOR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N FARNSWORTH AVE
AURORA IL
60505
US

IV. Provider business mailing address

1601 N FARNSWORTH AVE
AURORA IL
60505
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-1180
  • Fax: 630-898-1208
Mailing address:
  • Phone: 630-898-1180
  • Fax: 630-898-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0040097
License Number StateIL

VIII. Authorized Official

Name: JAMES L MANN
Title or Position: PRESIDENT
Credential:
Phone: 847-564-1880