Healthcare Provider Details

I. General information

NPI: 1164456851
Provider Name (Legal Business Name): HOSPICE OF ILLINOIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 E TOUHY AVE STE 170A
DES PLAINES IL
60018-5802
US

IV. Provider business mailing address

3010 LYNDON B JOHNSON FWY STE 1100
DALLAS TX
75234-2712
US

V. Phone/Fax

Practice location:
  • Phone: 224-244-7381
  • Fax: 773-539-4655
Mailing address:
  • Phone: 800-379-1600
  • Fax: 903-537-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2001923
License Number StateIL

VIII. Authorized Official

Name: KATIE MONASTIERE
Title or Position: COMPLIANCE AND PRIVACY OFFICER
Credential:
Phone: 800-379-1600