Provider Demographics
NPI:1881680536
Name:UNLIMITED DEVELOPMENT, INC
Entity type:Organization
Organization Name:UNLIMITED DEVELOPMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-343-1550
Mailing Address - Street 1:801 WEST MARTIN STREET
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:IL
Mailing Address - Zip Code:61410
Mailing Address - Country:US
Mailing Address - Phone:309-462-2356
Mailing Address - Fax:309-343-0981
Practice Address - Street 1:801 WEST MARTIN STREET
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:IL
Practice Address - Zip Code:61410
Practice Address - Country:US
Practice Address - Phone:309-462-2356
Practice Address - Fax:309-343-0981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0047951314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
145567Medicare Oscar/Certification