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FOR BHF USELL1 2017 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2017)I.DPH License ID Number:
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Administrator type or print is a document used to designate an individual or entity responsible for carrying out specific tasks.
Any individual or entity assigned as an administrator for specific tasks is required to file administrator type or print.
Administrator type or print can be filled out by providing the necessary information about the designated administrator and the tasks assigned to them.
The purpose of administrator type or print is to clearly designate and communicate responsibilities to the designated administrator.
Administrator type or print must include the name of the designated administrator, their contact information, and the specific tasks they are responsible for.
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