Provider Demographics
NPI:1750799821
Name:STONYBROOK CENTER INC.
Entity type:Organization
Organization Name:STONYBROOK CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-221-1400
Mailing Address - Street 1:27W281 GENEVA RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-2035
Mailing Address - Country:US
Mailing Address - Phone:630-221-1400
Mailing Address - Fax:630-221-1411
Practice Address - Street 1:27W281 GENEVA RD
Practice Address - Street 2:SUITE G
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2035
Practice Address - Country:US
Practice Address - Phone:630-221-1400
Practice Address - Fax:630-221-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041236060251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care