Healthcare Provider Details

I. General information

NPI: 1447224423
Provider Name (Legal Business Name): OREGON HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S 10TH ST
OREGON IL
61061-2129
US

IV. Provider business mailing address

7434 SKOKIE BLVD
SKOKIE IL
60077-3341
US

V. Phone/Fax

Practice location:
  • Phone: 815-732-7994
  • Fax: 815-732-7998
Mailing address:
  • Phone: 847-982-2300
  • Fax: 847-982-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0037838
License Number StateIL

VIII. Authorized Official

Name: MOE HERMAN
Title or Position: COMPTROLLER
Credential:
Phone: 847-982-2300