Healthcare Provider Details

I. General information

NPI: 1306180047
Provider Name (Legal Business Name): MORTON TERRACE HEALTHCARE AND REHABILITATION CENTRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 E QUEENWOOD RD
MORTON IL
61550-2956
US

IV. Provider business mailing address

191 E QUEENWOOD RD
MORTON IL
61550-2956
US

V. Phone/Fax

Practice location:
  • Phone: 309-266-5331
  • Fax: 309-266-9376
Mailing address:
  • Phone: 309-266-5331
  • Fax: 309-266-9376

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. KATHLEEN ADAMS
Title or Position: DIRECTOR OF ACCOUNTS RECEIVABLE
Credential:
Phone: 773-897-9231