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Organization

MCLEAN COUNTY NURSING HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SANDRA L WILES (ADM. ASST.)
(309) 888-5198
Entity
Organization

Contact information

Practice address
901 N MAIN ST, NORMAL, IL 61761-1501
(309) 888-5380
(309) 454-4594
Mailing address
901 N MAIN ST, NORMAL, IL 61761-1501
(309) 888-5380
(309) 454-4594

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0018150
IL

Other

Enumeration date
10/23/2008
Last updated
10/23/2008
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