Illinois Veterans Home At Quincy
Residential Treatment Facility, Physical Disabilities
1707 N 12th St, Quincy
Illinois, 62301-1355
217-222-8641 217-222-8578
Illinois Veterans Home At Quincy is a Residential Treatment Facility, Physical Disabilities in Quincy, Illinois. It is located at 1707 N 12th St, Quincy and it's customer support contact number is 217-222-8641. The authorized person of Illinois Veterans Home At Quincy is Bruce L Vaca, LNHA who is Administrator of this DME and his contact number is 217-222-8641. Active license number of Illinois Veterans Home At Quincy is 44107 for Residential Treatment Facility, Physical Disabilities in Illinois. Illinois Veterans Home At Quincy accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Illinois Veterans Home At Quincy is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
DME Supplier Details:
Illinois Veterans Home At Quincy type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Illinois Veterans Home At Quincy |
| Type: | Residential Treatment Facility, Physical Disabilities |
| Location: | 1707 N 12th St, Quincy,
Illinois, 62301-1355 |
| Phone: | 217-222-8641 |
| Fax: | 217-222-8578 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Bruce L Vaca |
| Credentials: | LNHA |
| Position: | Administrator |
| Contact Number: | 217-222-8641 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1386708568 |
| NPI Enumeration Date: | 21 Dec, 2006 |
| NPI Last Update On: | 15 Jul, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Illinois Veterans Home At Quincy are as mentioned below.
| Specialization | License Number | State | Status | |
| Residential Treatment Facility, Physical Disabilities | 44107 | Illinois | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Adult Care Home | 0044107 | Illinois | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 00122001 | Other | | Bcbs |
Medicare Enrollment:
Illinois Veterans Home At Quincy is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1355323361 | O20040603000715 | Illinois Veterans Home At Quincy | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1707 N 12th St, Bldg 29m
Quincy, Illinois |
| Zip: | 62301-1355 |
| Phone Number: | 217-222-9487 |
| Fax Number: | 217-222-8578 |
Patients can reach Illinois Veterans Home At Quincy at
1707 N 12th St, Quincy, Illinois or can
call on customer care at 217-222-8641.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.