Organization
NORTHERN ILLINOIS MEDICAL CENTER
Active
Parent organization
NORTHERN ILLINOIS MEDICAL CENTER
Other names
Centegra Home Health Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHERN ILLINOIS MEDICAL CENTER
Authorized official
DAVID TOMLINSON (CIO & CFO)
(815) 788-5831
Entity
Organization
Contact information
Practice address
213 FRONT ST, SUITE 2, MCHENRY, IL 60050-5501
(815) 344-6602
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 344-6602
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1003201
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9840
BLUE CROSS BLUE SHEILD
ID
Enumeration date
06/02/2006
Last updated
03/21/2014
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