Healthcare Provider Details

I. General information

NPI: 1851217186
Provider Name (Legal Business Name): ST MARYS HOSPITAL - KANKAKEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 W JEFFERSON ST STE 2614-A
JOLIET IL
60435-6433
US

IV. Provider business mailing address

2614 W JEFFERSON ST STE 2614-A
JOLIET IL
60435-6433
US

V. Phone/Fax

Practice location:
  • Phone: 815-773-7732
  • Fax:
Mailing address:
  • Phone: 815-773-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DOAN
Title or Position: MANAGING ASSOCIATE GENERAL COUNSEL
Credential:
Phone: 310-259-4706