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NPI Code Detail

MEDICARE: SERENITY HOSPICE AND HOME

MEDICARE: SERENITY HOSPICE AND HOME
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
1207QH0002XHospice and Palliative Medicine (Family Medicine) Physician
2207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician
3251G00000XCommunity Based Hospice Care Agency2000297IL

General Provider Information

NPI Number : 1184661100
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY HOSPICE AND HOME
Provider Business Mailing Address
First Line : 1658 S IL ROUTE 2
Second Line : P.O. BOX 462
City : OREGON
State : IL
Zip : 61061
Country : US
Telephone Number : 815-732-2499
Fax Number : 815-732-6077
Provider Business Practice Location Address
First Line : 1658 S IL ROUTE 2
Second Line :
City : OREGON
State : IL
Zip : 61061-9514
Country : US
Telephone Number : 815-732-2499
Fax Number : 815-732-6077
Authorized Official
Title or Position : CEO
Name : SUZANNE RAVLIN
Credential :
Telephone Number : 815-732-2499
Provider Enumeration Date : 05/31/2006
Last Update Date : 03/20/2025

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Directions to “SERENITY HOSPICE AND HOME ” Practice Location

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