Healthcare Provider Details

I. General information

NPI: 1902971021
Provider Name (Legal Business Name): SPRING VALLEY NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 NORTH GREENWOOD ST
SPRING VALLEY IL
61362-1576
US

IV. Provider business mailing address

1300 NORTH GREENWOOD ST
SPRING VALLEY IL
61362-1576
US

V. Phone/Fax

Practice location:
  • Phone: 815-664-4708
  • Fax: 815-663-2527
Mailing address:
  • Phone: 815-664-4708
  • Fax: 815-663-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0025270
Identifier TypeMEDICAID
Identifier StateIL
Identifier Issuer

VIII. Authorized Official

Name: MR. MORRIS STEINBERG
Title or Position: MANAGER
Credential:
Phone: 815-664-4708