Basic Information
| Provider Information | |||||||||
| NPI: | 1982648150 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HELIA HEALTHCARE OF URBANA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 WESTGATE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | OAK PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129942306 | ||||||||
| FaxNumber: | 3128965951 | ||||||||
| Practice Location | |||||||||
| Address1: | 907 N LINCOLN AVE | ||||||||
| Address2: | |||||||||
| City: | URBANA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 618011526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173678421 | ||||||||
| FaxNumber: | 3173670522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3129942306 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 0041897 | IL | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.