Organization
EAST BANK CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS EDNA L LOPEZ (ADMINISTRATOR)
(815) 633-6810
Entity
Organization
Contact information
Practice address
6131 PARK RIDGE RD, LOVES PARK, IL 61111-4029
(815) 633-6810
(815) 633-5095
Mailing address
12040 RAYMOND CT, HUNTLEY, IL 60142-8069
(847) 515-1505
(847) 515-1503
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0047209
IL
Other
Enumeration date
01/24/2007
Last updated
10/26/2011
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