Healthcare Provider Details

I. General information

NPI: 1528652971
Provider Name (Legal Business Name): BROOKSTONE ESTATES OF RANTOUL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TWIN LAKES DR
RANTOUL IL
61866-2663
US

IV. Provider business mailing address

200 E COURT ST STE 400
KANKAKEE IL
60901-3848
US

V. Phone/Fax

Practice location:
  • Phone: 309-808-6764
  • Fax:
Mailing address:
  • Phone: 815-935-1992
  • Fax: 815-935-8380

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: 847-274-9596