Healthcare Provider Details

I. General information

NPI: 1598033904
Provider Name (Legal Business Name): SYMPHONY DEERBROOK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 N LARKIN AVE
JOLIET IL
60435-6698
US

IV. Provider business mailing address

306 N LARKIN AVE
JOLIET IL
60435-6698
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-5560
  • Fax: 815-744-6914
Mailing address:
  • Phone: 815-744-5560
  • Fax: 815-744-6914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0040741
License Number StateIL

VIII. Authorized Official

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