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NPI Code Detail

MEDICARE: HOLY FAMILY VILLA

MEDICARE: HOLY FAMILY VILLA
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
1314000000XSkilled Nursing Facility0045393IL

General Provider Information

NPI Number : 1740239334
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLY FAMILY VILLA
Provider Business Mailing Address
First Line : 12220 WILL COOK RD
Second Line :
City : PALOS PARK
State : IL
Zip : 60464-7332
Country : US
Telephone Number : 630-257-2291
Fax Number :
Provider Business Practice Location Address
First Line : 12220 WILL COOK RD
Second Line :
City : PALOS PARK
State : IL
Zip : 60464-7332
Country : US
Telephone Number : 630-257-2291
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. ROBERTA J. MAGURANY
Credential :
Telephone Number : 630-257-2291
Provider Enumeration Date : 05/09/2006
Last Update Date : 07/06/2018

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Directions to “HOLY FAMILY VILLA ” Practice Location

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