Provider Demographics
NPI:1316232184
Name:DOBSON PLAZA NURSING & REHAB CENTER, L.L.C.
Entity type:Organization
Organization Name:DOBSON PLAZA NURSING & REHAB CENTER, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-521-2467
Mailing Address - Street 1:120 DODGE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3622
Mailing Address - Country:US
Mailing Address - Phone:847-869-7744
Mailing Address - Fax:849-570-0112
Practice Address - Street 1:120 DODGE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3622
Practice Address - Country:US
Practice Address - Phone:847-869-7744
Practice Address - Fax:849-570-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145122Medicare Oscar/Certification