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NPI Code Detail

MEDICARE: BROOKSTONE ESTATES OF OLNEY

MEDICARE: BROOKSTONE ESTATES OF OLNEY
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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1366103731
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKSTONE ESTATES OF OLNEY
Provider Business Mailing Address
First Line : 200 E COURT ST STE 400
Second Line :
City : KANKAKEE
State : IL
Zip : 60901-3848
Country : US
Telephone Number : 815-935-1992
Fax Number : 815-935-8380
Provider Business Practice Location Address
First Line : 1110 N EAST ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-6902
Country : US
Telephone Number : 618-392-5870
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JEROME FINIS
Credential :
Telephone Number : 847-274-9596
Provider Enumeration Date : 01/06/2022
Last Update Date : 01/06/2026

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Directions to “BROOKSTONE ESTATES OF OLNEY ” Practice Location

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