Provider Demographics
NPI:1245489855
Name:PREFERRED CARE LLC
Entity type:Organization
Organization Name:PREFERRED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:MCCORKHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-715-5743
Mailing Address - Street 1:710 SNYDER ST
Mailing Address - Street 2:
Mailing Address - City:RANTOUL
Mailing Address - State:IL
Mailing Address - Zip Code:61866-3684
Mailing Address - Country:US
Mailing Address - Phone:217-892-2800
Mailing Address - Fax:
Practice Address - Street 1:200 INTERNATIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:RANTOUL
Practice Address - State:IL
Practice Address - Zip Code:61866
Practice Address - Country:US
Practice Address - Phone:217-892-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANUTE RETIREMENT JOINT VENTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5102279310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility