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General NPI Number Information
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NPI Number | 1265495436
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Entity Type | Organization
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Legal Business Name | WILLEMOORE INC.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 12400 S. HARLEM AVE SUITE 111
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1476
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Country | US
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Telephone | 708-424-7800
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Fax | 708-424-9323
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Provider Business Mailing Address
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Address Line | 12400 S. HARLEM AVE SUITE 111
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1476
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Country | US
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Telephone | 708-424-7800
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Fax | 708-424-9323
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CHARLENE MILLER
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Credential |
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Telephone | 239-275-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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