Healthcare Provider Details

I. General information

NPI: 1427077601
Provider Name (Legal Business Name): WINNING WHEELS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 3RD ST
PROPHETSTOWN IL
61277-1334
US

IV. Provider business mailing address

701 E 3RD ST
PROPHETSTOWN IL
61277-1334
US

V. Phone/Fax

Practice location:
  • Phone: 815-537-5168
  • Fax: 815-537-5268
Mailing address:
  • Phone: 815-537-5168
  • Fax: 815-537-5268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ALAN GAPINSKI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 815-778-3683