Healthcare Provider Details
I. General information
NPI: 1467246355
Provider Name (Legal Business Name): REMEDIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8303 HOPEDALE RD
HOPEDALE IL
61747-9672
US
IV. Provider business mailing address
8303 HOPEDALE RD
HOPEDALE IL
61747-9672
US
V. Phone/Fax
- Phone: 309-363-1047
- Fax:
- Phone: 309-363-1047
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNABELLE
DAYOLA
Title or Position: PRESIDENT
Credential: APN
Phone: 309-439-9400