MEDICARE: MIDAMERICA CARE FOUNDATION

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
1	314000000X	Skilled Nursing Facility	0029322	IL

General Provider Information

NPI Number	:	1821098799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDAMERICA CARE FOUNDATION

Provider Business Mailing Address
First Line	:	900 KIWANIS DR
Second Line	:
City	:	FREEPORT
State	:	IL
Zip	:	61032-4580
Country	:	US
Telephone Number	:	815-235-6196
Fax Number	:	815-235-5365

Provider Business Practice Location Address
First Line	:	900 KIWANIS DR
Second Line	:
City	:	FREEPORT
State	:	IL
Zip	:	61032-4580
Country	:	US
Telephone Number	:	815-235-6196
Fax Number	:	815-235-5365

Authorized Official
Title or Position	:	PRESIDENT, CEO
Name	:	JOSEPH C TUTERA
Credential	:
Telephone Number	:	816-444-0900

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/22/2020

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Directions to “MIDAMERICA CARE FOUNDATION ” Practice Location

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