Healthcare Provider Details

I. General information

NPI: 1295814556
Provider Name (Legal Business Name): PIATT CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N STATE ST
MONTICELLO IL
61856
US

IV. Provider business mailing address

PO BOX 410
MONTICELLO IL
61856
US

V. Phone/Fax

Practice location:
  • Phone: 217-762-2506
  • Fax: 217-762-6325
Mailing address:
  • Phone: 217-762-2506
  • Fax: 217-762-6325

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: KARLA L BRADLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 217-762-6303