Healthcare Provider Details

I. General information

NPI: 1699927335
Provider Name (Legal Business Name): ZION CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 27TH ST
ZION IL
60099-2541
US

IV. Provider business mailing address

1625 S 6TH ST
SPRINGFIELD IL
62703-2828
US

V. Phone/Fax

Practice location:
  • Phone: 847-746-3736
  • Fax:
Mailing address:
  • Phone: 217-528-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY E STROISCH
Title or Position: DIR OF FIN SERV
Credential:
Phone: 217-528-2244