Healthcare Provider Details

I. General information

NPI: 1922197383
Provider Name (Legal Business Name): COUNTY OF VERMILION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14792 CATLIN TILTON RD
DANVILLE IL
61834-5116
US

IV. Provider business mailing address

14792 CATLIN TILTON RD
DANVILLE IL
61834-5116
US

V. Phone/Fax

Practice location:
  • Phone: 217-443-6430
  • Fax: 217-443-1558
Mailing address:
  • Phone: 217-443-6430
  • Fax: 217-443-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CATHERINE HIX
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 217-443-6430