Organization
PARADOX DECATUR OPERATOR LLC
Active
Other names
Decatur Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ROTHNER (MANAGER)
(847) 905-4000
Entity
Organization
Contact information
Practice address
444 W HARRISON AVE, DECATUR, IL 62526-4157
(217) 877-7333
Mailing address
6840 N LINCOLN AVE, LINCOLNWOOD, IL 60712-2628
(847) 675-7979
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055418
IL DEPARTMENT PUBLIC HEALTH
IL
Enumeration date
12/05/2018
Last updated
12/05/2018
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