Healthcare Provider Details

I. General information

NPI: 1992520084
Provider Name (Legal Business Name): CRESCENT HOSPICE AND PALLIATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24047 W LOCKPORT ST STE 201A
PLAINFIELD IL
60544-1680
US

IV. Provider business mailing address

24047 W LOCKPORT ST STE 201A
PLAINFIELD IL
60544-1680
US

V. Phone/Fax

Practice location:
  • Phone: 815-531-7935
  • Fax:
Mailing address:
  • Phone: 815-531-7935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANALEE ACEDERA NAVARRO
Title or Position: SECRETARY
Credential: RN
Phone: 815-531-7935