Healthcare Provider Details

I. General information

NPI: 1609076835
Provider Name (Legal Business Name): DSI WATSEKA OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 E MARTIN AVE
WATSEKA IL
60970-2000
US

IV. Provider business mailing address

577 E MARTIN AVE
WATSEKA IL
60970-2000
US

V. Phone/Fax

Practice location:
  • Phone: 815-432-4560
  • Fax: 815-432-4562
Mailing address:
  • Phone: 815-432-4560
  • Fax: 815-432-4562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. GREGORY ECHOLS
Title or Position: CO CEO
Credential:
Phone: 779-216-5849