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NPI Code Detail

MEDICARE: SINNISSIPPI CENTERS, INC.

MEDICARE: SINNISSIPPI CENTERS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care AgencyIL

General Provider Information

NPI Number : 1578664868
Entity Type Code : Organization
Provider Name (Legal Business Name) : SINNISSIPPI CENTERS, INC.
Provider Business Mailing Address
First Line : 3 OMALLEY CT
Second Line :
City : OHIO
State : IL
Zip : 61349-9533
Country : US
Telephone Number : 815-878-6689
Fax Number :
Provider Business Practice Location Address
First Line : 325 IL ROUTE 2
Second Line :
City : DIXON
State : IL
Zip : 61021-9118
Country : US
Telephone Number : 815-284-6611
Fax Number : 815-284-6641
Authorized Official
Title or Position : VICE PRESIDENT
Name : MRS. TERESA GOOD
Credential : CFO
Telephone Number : 815-284-6611
Provider Enumeration Date : 09/26/2006
Last Update Date : 08/22/2020

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1518073139 — MRS. MARY ANN SCUFFHAM RNC
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1992814792 — MR. THOMAS JAMES HERMES LCSW
Practice Location Address:
325 IL ROUTE 2
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1932299138 — MS. ALISA WOLF LCSW
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325 IL ROUTE 2
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Directions to “SINNISSIPPI CENTERS, INC. ” Practice Location

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