NPI 1194703702

Petersen Health Care VII LLC

Organisation Skilled Nursing Facility Sullivan, IL

Practice location

Address: 1 Masonic Way, Sullivan, IL 61951-9467
Phone: (217) 728-7394
Fax: (217) 728-4221

Authorised official

Name: Mark Petersen
Title: President
Phone: (309) 691-8113

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 0010249 (IL)

Other Skilled Nursing Facility providers in Illinois →

Registry record

NPI: 1194703702
Entity type: Organization
NPI issued: 4 Jan 2006
Record last updated: 27 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.