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Organization

DUPAGE CONVALESCENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER M ULMER LNHA (ADMINISTRATOR)
(630) 784-4202
Entity
Organization

Contact information

Practice address
400 N COUNTY FARM RD, WHEATON, IL 60187-3908
(630) 784-4201
(630) 784-4203
Mailing address
400 N COUNTY FARM RD, WHEATON, IL 60187-3908
(630) 784-4201
(630) 784-4203

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0008201
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36600651002
ROOM AND BOARD
IL
Enumeration date
06/27/2008
Last updated
01/14/2015
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