Provider Demographics
NPI:1609043074
Name:MARKUND CHILDRENS HOME
Entity Type:Organization
Organization Name:MARKUND CHILDRENS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-593-5500
Mailing Address - Street 1:1S450 WYATT DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4921
Mailing Address - Country:US
Mailing Address - Phone:630-593-5500
Mailing Address - Fax:
Practice Address - Street 1:164 S PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1626
Practice Address - Country:US
Practice Address - Phone:630-529-2871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARKLUND CHILDRENS HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-14
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0000112883140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric