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FOR BHF USELL1 2015 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2015)I.DPH License ID Number:

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Anyone who qualifies as a medical provider under www2illinoisgov hfs medicalprovidershfs 3745c may need to fill out this form. This can include healthcare professionals, clinics, hospitals, or any other entities seeking to become or remain providers under the Illinois Department of Healthcare and Family Services.

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What is www2illinoisgov hfs medicalprovidershfs 3745c?

This form is a document used by medical providers in Illinois to report certain information to the Illinois Department of Healthcare and Family Services.

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All medical providers in Illinois who meet the filing requirements set by the Illinois Department of Healthcare and Family Services.

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Medical providers can fill out the form electronically on the Illinois Department of Healthcare and Family Services website or submit a paper copy by mail.

What is the purpose of www2illinoisgov hfs medicalprovidershfs 3745c?

The purpose of this form is to collect important information from medical providers in Illinois for regulatory and compliance purposes.

What information must be reported on www2illinoisgov hfs medicalprovidershfs 3745c?

The form may require information such as provider details, billing information, and other relevant healthcare data.

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