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FOR BHF USELL1 2019STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2019) I.DPH License ID Number:

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Start by writing the street number '800' in the first line of the address.

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Next, write 'Division Street' in the second line as the name of the street.

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