| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1093706137 | HERITAGE MANOR - EL PASO, LLC | 115 W JEFFERSON ST | BLOOMINGTON | IL | 617013946 | |||
| 1851635569 | HERITAGE MANOR - EL PASO, LLC | 115 W JEFFERSON ST | BLOOMINGTON | IL | 617013946 | |||
| 1558489526 | WILSON | JAN | 1702 LONGDEN AVE | BLOOMINGTON | IL | 617018304 |