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Organization

COUNTY OF MCLEAN

Active
Other names
McLean County Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA L WEGNER (ADMINISTRATOR)
(309) 888-5380
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
314000000X
Skilled Nursing Facility
Primary
0018150
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0018150
STATE LICENSE NUMBER
IL
05
37600156801
IL
Enumeration date
10/13/2005
Last updated
12/28/2015
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