Provider Demographics
NPI:1215007588
Name:THE TILLERS NURSING AND REHABILITATION CENTER
Entity Type:Organization
Organization Name:THE TILLERS NURSING AND REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING DIRECTOR AND BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:LYNDSEE
Authorized Official - Last Name:SAXON SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-554-1001
Mailing Address - Street 1:PO BOX 950
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-0950
Mailing Address - Country:US
Mailing Address - Phone:630-554-1001
Mailing Address - Fax:630-554-1668
Practice Address - Street 1:4390 STATE ROUTE 71
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-9866
Practice Address - Country:US
Practice Address - Phone:630-554-1001
Practice Address - Fax:630-554-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0018002314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146034Medicare ID - Type Unspecified