Organization
OTTAWA PAVILION, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHALL A MAUER (SECRETARY-TREASURER)
(847) 679-8219
Entity
Organization
Contact information
Practice address
704 E GLOVER ST, OTTAWA, IL 61350-4131
(815) 431-4900
(815) 434-2376
Mailing address
704 E GLOVER ST, OTTAWA, IL 61350-4131
(815) 431-4900
(815) 434-2376
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0039230
IL
Other
Enumeration date
12/28/2005
Last updated
01/14/2015
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