Organization
ASTA CARE CENTER OF PONTIAC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GILLMAN (PRESIDENT)
(847) 742-8822
Entity
Organization
Contact information
Practice address
300 W LOWELL, PONTIAC, IL 61764-2614
(815) 842-1181
Mailing address
300 W LOWELL, PONTIAC, IL 61764-2614
(815) 842-1181
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
0043968
IL
Other
Enumeration date
11/04/2005
Last updated
05/10/2013
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