Healthcare Provider Details

I. General information

NPI: 1720249394
Provider Name (Legal Business Name): EMERITUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 E AMBER LN
URBANA IL
61802-6907
US

IV. Provider business mailing address

1706 E AMBER LN
URBANA IL
61802-6907
US

V. Phone/Fax

Practice location:
  • Phone: 217-328-3150
  • Fax: 217-328-3152
Mailing address:
  • Phone: 217-328-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number5100349
License Number StateIL

VIII. Authorized Official

Name: ANNA F.C. MUNOZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 414-918-5443