Healthcare Provider Details

I. General information

NPI: 1285268326
Provider Name (Legal Business Name): ELYSIAN HOSPICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E JACKSON ST STE 6
MORTON IL
61550-1616
US

IV. Provider business mailing address

320 E JACKSON ST STE 6
MORTON IL
61550-1616
US

V. Phone/Fax

Practice location:
  • Phone: 309-699-4715
  • Fax: 309-699-4717
Mailing address:
  • Phone: 309-699-4715
  • Fax: 309-699-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY W HIXON
Title or Position: OWNER/CFO
Credential:
Phone: 309-699-4715