Healthcare Provider Details

I. General information

NPI: 1922268416
Provider Name (Legal Business Name): DIXON HEALTHCARE & REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DIVISION ST
DIXON IL
61021-4107
US

IV. Provider business mailing address

800 DIVISION ST
DIXON IL
61021-4107
US

V. Phone/Fax

Practice location:
  • Phone: 815-284-3393
  • Fax: 815-284-2066
Mailing address:
  • Phone: 815-284-3393
  • Fax: 815-284-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0045948
License Number StateIL

VIII. Authorized Official

Name: MS. KIMBERLY A WESTERKAMP
Title or Position: COO
Credential:
Phone: 630-655-9104