Organization
COUNTY OF MCDONOUGH MCDONOUGH COUNTY CLERK
Active
Other names
The Elms
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA WINDSOR AUTHRORIZED OFFICIAL (INTERIM ADMINISTRATOR)
(309) 837-5482
Entity
Organization
Contact information
Practice address
1212 MADELYN AVENUE, MACOMB, IL 61455
(309) 837-5482
(309) 833-1054
Mailing address
1212 MADELYN AVENUE, MACOMB, IL 61455
(309) 837-5482
(309) 833-1054
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0021568
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021568
PUBLIC HEALTH I.D. NUMBER
IL
Enumeration date
06/21/2005
Last updated
04/10/2019
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