Healthcare Provider Details

I. General information

NPI: 1316232184
Provider Name (Legal Business Name): DOBSON PLAZA NURSING & REHAB CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 DODGE AVE
EVANSTON IL
60202-3622
US

IV. Provider business mailing address

120 DODGE AVE
EVANSTON IL
60202-3622
US

V. Phone/Fax

Practice location:
  • Phone: 847-869-7744
  • Fax: 849-570-0112
Mailing address:
  • Phone: 847-869-7744
  • Fax: 849-570-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. FRANCES MEEHAN
Title or Position: ATTORNEY
Credential:
Phone: 312-521-2467