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NPI Code Detail

MEDICARE: JOLIET AREA COMMUNITY HOSPICE CORPORATION

MEDICARE: JOLIET AREA COMMUNITY HOSPICE CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1315D00000XInpatient Hospice0722000340IL
2363L00000XNurse Practitioner
3385H00000XRespite Care
4251G00000XCommunity Based Hospice Care Agency0722000339IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10004423721OTHERILAETNA
29518OTHERBCBS OF IL
3103501032395OTHERILHUMANA

General Provider Information

NPI Number : 1043212103
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOLIET AREA COMMUNITY HOSPICE CORPORATION
Provider Business Mailing Address
First Line : 250 WATER STONE CIR
Second Line :
City : JOLIET
State : IL
Zip : 60431-8313
Country : US
Telephone Number : 815-740-4104
Fax Number : 815-740-4107
Provider Business Practice Location Address
First Line : 250 WATER STONE CIR
Second Line :
City : JOLIET
State : IL
Zip : 60431-8313
Country : US
Telephone Number : 815-740-4104
Fax Number : 815-740-4107
Authorized Official
Title or Position : CEO
Name : MARY KAY SHEEHAN
Credential :
Telephone Number : 815-740-4104
Provider Enumeration Date : 06/02/2005
Last Update Date : 07/03/2024

Similar Medicare Providers

1164066718 — JANELL LYNN MCBOOM LCSW
Practice Location Address:
250 WATER STONE CIR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax:
1558386581 — MONA TAREEN M.D.
Practice Location Address:
250 WATER STONE CIR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax:
1285707877 — MS. MARALINE PATRICIA MATTKE M.S.W., L.C.S.W.
Practice Location Address:
250 WATER STONE CIR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax: 815-740-4107
1891992681 — MISS VEVECA A TIKASINGH L.C.S.W
Practice Location Address:
250 WATERSTONE CIRCLE DR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax: 815-740-4107
1376740696 — PHYLLIS M SPINAL-ROBINSON L.C.S.W
Practice Location Address:
250 WATER STONE CIR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax: 815-740-4107
1760689145 — RUBY DIANNE RICHARDSON LCSW
Practice Location Address:
250 WATER STONE CIR
JOLIET, IL
60431-8313
Practice Phone: 815-740-4104
Practice Fax: 815-740-4107

Directions to “JOLIET AREA COMMUNITY HOSPICE CORPORATION ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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