Healthcare Provider Details

I. General information

NPI: 1982648150
Provider Name (Legal Business Name): HELIA HEALTHCARE OF URBANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 N LINCOLN AVE
URBANA IL
61801-1526
US

IV. Provider business mailing address

1111 WESTGATE SUITE 110
OAK PARK IL
60301
US

V. Phone/Fax

Practice location:
  • Phone: 217-367-8421
  • Fax: 317-367-0522
Mailing address:
  • Phone: 312-994-2306
  • Fax: 312-896-5951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0041897
License Number StateIL

VIII. Authorized Official

Name: STEPHEN P MILLER
Title or Position: MEMBER
Credential:
Phone: 312-994-2306