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Health Financial Systems BCC DBA KILLING COMMUNITY HOSPITAL In Lieu of Form CMS255210 This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim FORM
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BCC DBA Illini Community is a Doing Business As (DBA) name used by a specific community or organization.
Any business or organization using the DBA name BCC DBA Illini Community is required to file it.
To fill out BCC DBA Illini Community, the organization must provide relevant information about the business and the purpose of using this DBA name.
The purpose of BCC DBA Illini Community is to allow a community or organization to conduct business under a different name than their legal entity name.
Information such as the legal entity name, address, purpose of using the DBA name, and contact information must be reported on BCC DBA Illini Community.
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