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General NPI Number Information
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NPI Number | 1033166160
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Entity Type | Organization
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Legal Business Name | BALLARD NURSING CENTER, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 9300 W BALLARD RD
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City | DES PLAINES
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State | IL
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Zip | 60016-4904
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Country | US
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Telephone | 847-294-2300
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Fax | 847-299-4012
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Provider Business Mailing Address
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Address Line | 9300 W BALLARD RD
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City | DES PLAINES
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State | IL
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Zip | 60016-4904
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Country | US
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Telephone | 847-294-2300
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Fax | 847-299-4012
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. MARK PICK
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Credential |
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Telephone | 847-294-2308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0023093
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License Number State | IL
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