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FOR OH FUSE LL1 2002 STATE OF ILLINOIS DEPARTMENT OF PUBLIC AID FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES (FISCAL YEAR 2002) I. DPH Facility ID Number: Facility Name: 0035618
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The purpose of the form is to report healthcare information accurately.
Information such as patient details, services provided, and billing information must be reported.
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ILLINOIS BRYN MAWR 2001 2000 ACCNT VII LLC VIII Subunits ECM 12I OHF 10a 12B MAINT Alloc IDPH GIANNINI SERV SNF LINCOLNWOOD ECMOC AVG XCEL MGMNT WKD ICF xii reclassification 12A

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