Healthcare Provider Details

I. General information

NPI: 1871581769
Provider Name (Legal Business Name): ST. ANN'S HEALTHCARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 STATE ST
CHESTER IL
62233-1642
US

IV. Provider business mailing address

770 STATE ST
CHESTER IL
62233-1642
US

V. Phone/Fax

Practice location:
  • Phone: 618-826-2314
  • Fax: 618-826-5047
Mailing address:
  • Phone: 618-826-2314
  • Fax: 618-826-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0023390
License Number StateIL

VIII. Authorized Official

Name: J MICHAEL GREER
Title or Position: PRESIDENT/OWNER
Credential: NHA
Phone: 618-826-2314