Organization
MCKINLEY COURT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CHARLES BRAUN (CONTROLLER)
(847) 583-0100
Entity
Organization
Contact information
Practice address
500 W MCKINLEY AVE, DECATUR, IL 62526-3281
(217) 875-0020
(217) 875-0647
Mailing address
500 W MCKINLEY AVE, DECATUR, IL 62526-3281
(217) 875-0020
(217) 875-0647
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
42499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42499
IDPH LICENSE NUMBER
IL
01
—
6005938
IDPH FACILITY NUMBER
IL
Enumeration date
12/20/2005
Last updated
10/04/2011
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