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General NPI Number Information
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NPI Number | 1679959357
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Entity Type | Organization
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Legal Business Name | RUSHVILLE NURSING AND REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 135 S MORGAN ST
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City | RUSHVILLE
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State | IL
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Zip | 62681-1617
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Country | US
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Telephone | 217-322-3420
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Fax | 217-322-2828
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Provider Business Mailing Address
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Address Line | 2201 MAIN ST
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City | EVANSTON
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State | IL
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Zip | 60202-1519
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Country | US
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Telephone | 847-905-4000
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Fax | 847-905-4040
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Authorized Official
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Title or Position | OWNER
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Name | SHERWIN RAY
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Credential |
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Telephone | 847-905-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 145488
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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