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FOR BHF USELL1
2013
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2013)I.DPH License ID Number:
Facility
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Step 1: Begin by gathering all the necessary information, such as the correct address, contact details, and any other required details.
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Step 3: Start by entering the address line by line. Enter '1026' in the 'Street Number' field.
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Step 4: Enter 'N' in the 'Street Name' field.
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Step 5: Enter 'Merchant' in the 'Street Type' field.
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Step 6: Enter 'St' in the 'Street Suffix' field.
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