Healthcare Provider Details

I. General information

NPI: 1912982331
Provider Name (Legal Business Name): THE MCALLISTER NURSING HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 SOUTH LAVERGNE AVENUE
TINLEY PARK IL
60477
US

IV. Provider business mailing address

18300 SOUTH LAVERGNE AVENUE
TINLEY PARK IL
60477
US

V. Phone/Fax

Practice location:
  • Phone: 708-798-2272
  • Fax: 708-798-2272
Mailing address:
  • Phone: 708-798-2272
  • Fax: 708-798-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0026989
License Number StateIL

VIII. Authorized Official

Name: MRS. GERALDINE WAGNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 708-798-2272