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FOR BHF USELL1 2021STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2021) I.DPH License ID Number: Facility

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How to fill out facility name amp id

01

Locate the facility name field on the form.

02

Enter the name of the facility in the designated space.

03

Locate the facility ID field on the form.

04

Enter the facility ID number in the designated space.

Who needs facility name amp id?

01

Individuals who are registering a facility for a specific purpose.

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Organizations that require identification of facilities for tracking or record-keeping purposes.

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What is facility name amp id?

Facility name amp id is a unique identifier given to a facility or location.

Who is required to file facility name amp id?

All businesses and organizations with a physical location or facility are required to file a facility name amp id.

How to fill out facility name amp id?

Facility name amp id can be filled out electronically or by submitting a paper form with the required information.

What is the purpose of facility name amp id?

The purpose of facility name amp id is to accurately identify and track different facilities or locations.

What information must be reported on facility name amp id?

Facility name, address, type of facility, and contact information must be reported on facility name amp id.

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