Organization
RESTHAVE HOME OF WHITESIDE COUNTY ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMI SUE TEGELER (EXECUTIVE DIRECTOR)
(815) 772-4021
Entity
Organization
Contact information
Practice address
408 MAPLE AVE, MORRISON, IL 61270-2936
(815) 772-4021
(815) 772-4583
Mailing address
408 MAPLE AVE, MORRISON, IL 61270-2936
(815) 772-4021
(815) 772-4583
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0005785
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14E288
—
IL
01
—
IL6007884
FACILITY USER NAME
IL
Enumeration date
09/21/2005
Last updated
06/27/2016
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