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FOR BHF USELL1 2011 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2011)I.DPH License ID Number:
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Administrator type or print is a form used for reporting administrator information.
Individuals or entities appointed as administrators of a particular system or organization are required to file administrator type or print.
Administrator type or print can be filled out by providing all the necessary information requested on the form.
The purpose of administrator type or print is to provide a record of the administrators associated with a specific system or organization.
Administrator type or print must include information such as name, contact details, role/title, and responsibilities.
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