Ottawa Pavilion, Ltd.

NPI 1205813490 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1205813490
Enumeration Date 12/28/2005
Last Updated 01/14/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARSHALL A MARSHALL
Position SECRETARY-TREASURER
Phone (815) 431-4900
Fax (815) 434-2376
Practice Location
704 E GLOVER ST
OTTAWA IL, 61350-4131, US
Phone (815) 431-4900
Fax (815) 434-2376
Business Location
704 E GLOVER ST
OTTAWA IL, 61350-4131, US
Phone (815) 431-4900
Fax (815) 434-2376
Toxanomy
Taxonomy Code 314000000X
License State Illinois
License Number 0039230
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According to our database, Ottawa Pavilion, Ltd. NPI is 1205813490, taxonomy code is 314000000X and license number is 0039230, license state is located at Illinois. Ottawa Pavilion, Ltd. physically located at 704 E Glover St, Ottawa IL, 61350-4131. NPI Number 1033115704 has the healthcare provider type.

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1205813490 NPI number is provided on an as is basis without warranty of any kind. 1205813490 is maintained by the National Plan & Provider Enumeration System. The contents of Ottawa Pavilion, Ltd. are for informational purposes only.