Provider Demographics
NPI:1255597720
Name:WINNING WHEELS INC
Entity type:Organization
Organization Name:WINNING WHEELS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-778-3683
Mailing Address - Street 1:501 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNDON
Mailing Address - State:IL
Mailing Address - Zip Code:61261-9772
Mailing Address - Country:US
Mailing Address - Phone:815-273-2105
Mailing Address - Fax:
Practice Address - Street 1:1125 N 5TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNA
Practice Address - State:IL
Practice Address - Zip Code:61074-9700
Practice Address - Country:US
Practice Address - Phone:815-273-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility