Healthcare Provider Details

I. General information

NPI: 1225853161
Provider Name (Legal Business Name): HIGHLIGHT HC OF ROCHELLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 N CARON RD
ROCHELLE IL
61068-9647
US

IV. Provider business mailing address

2711 W HOWARD ST
CHICAGO IL
60645-1303
US

V. Phone/Fax

Practice location:
  • Phone: 815-562-4047
  • Fax: 815-562-8017
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: YOSEF TSADOK
Title or Position: MANAGER
Credential:
Phone: 815-562-4047