Organization · Type 2 NPI

Sullivan Hco, LLC

Skilled Nursing Facility · Sullivan, IL

NPI number 1417913583 Active

Practice location

11 Hawthorne Ln
Sullivan, IL 61951-9490

Call (217) 728-4327 Map

Fax (217) 728-2263

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	0046425 (IL)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

7 other providers at this address

Other skilled nursing facility providers in Sullivan

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NPI record

NPI: 1417913583
Entity type: Organization (Type 2)
Issued: Apr 26, 2006
Last updated: Sep 24, 2020
Status: Active

Other names

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Sullivan Rehabilitation & Health Care Center · doing business as
Sullivan Rehabilitation & Health Care Center · doing business as

Authorized official

Mark B. Petersen
Manager
(309) 689-5880

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1417913583

Sullivan Hco, LLC's National Provider Identifier is 1417913583, issued on Apr 26, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Sullivan, IL. The record was last updated on Sep 24, 2020.