Healthcare Provider Details

I. General information

NPI: 1821240722
Provider Name (Legal Business Name): DANVILLE CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N BOWMAN AVENUE RD
DANVILLE IL
61832-2200
US

IV. Provider business mailing address

1701 N BOWMAN AVENUE RD
DANVILLE IL
61832-2200
US

V. Phone/Fax

Practice location:
  • Phone: 217-443-2955
  • Fax: 217-443-0315
Mailing address:
  • Phone: 217-443-2955
  • Fax: 217-443-0315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0032862
License Number StateIL

VIII. Authorized Official

Name: MRS. KATHERINE J MURPHY
Title or Position: ASST CONTROLLER
Credential: MHA
Phone: 217-637-2794