Healthcare Provider Details
I. General information
NPI: 1649643628
Provider Name (Legal Business Name): APERION CARE BLOOMINGTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1509 CALHOUN ST
BLOOMINGTON IL
61701-1514
US
IV. Provider business mailing address
8131 MONTICELLO AVE
SKOKIE IL
60076-3325
US
V. Phone/Fax
- Phone: 309-827-6046
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YOSEF
MEYSTEL
Title or Position: MEMBER
Credential:
Phone: 847-673-6767