Healthcare Provider Details

I. General information

NPI: 1336299544
Provider Name (Legal Business Name): PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W COURT ST
KANKAKEE IL
60901-3661
US

IV. Provider business mailing address

500 W COURT ST
KANKAKEE IL
60901-3661
US

V. Phone/Fax

Practice location:
  • Phone: 815-937-2470
  • Fax: 815-937-8743
Mailing address:
  • Phone: 815-937-2470
  • Fax: 815-937-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAULA CAMPBELL
Title or Position: SYSTEM FINANCE OFFICER
Credential:
Phone: 312-308-3981