Healthcare Provider Details

I. General information

NPI: 1184218539
Provider Name (Legal Business Name): BROOKSTONE ESTATES OF PARIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 BROOKSTONE EST
PARIS IL
61944-9603
US

IV. Provider business mailing address

30 S WACKER DR STE 1300
CHICAGO IL
60606-7466
US

V. Phone/Fax

Practice location:
  • Phone: 812-645-3994
  • Fax:
Mailing address:
  • Phone: 312-837-0701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JEROME E FINIS
Title or Position: MANAGER
Credential:
Phone: 312-837-0704