MEDICARE: DELNOR COMMUNITY HOSPITAL

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
1	251E00000X	Home Health Agency	1001627	IL

General Provider Information

NPI Number	:	1598768608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELNOR COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	964 N 5TH AVE
Second Line	:	BUILDING C
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-1204
Country	:	US
Telephone Number	:	630-513-0370
Fax Number	:	630-513-8462

Provider Business Practice Location Address
First Line	:	964 N 5TH AVE
Second Line	:	BUILDING C
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-1204
Country	:	US
Telephone Number	:	630-513-0370
Fax Number	:	630-513-8462

Authorized Official
Title or Position	:	VP/CHIEF FINANCIAL OFFICER
Name	:	MR. MICHAEL KITTOE
Credential	:
Telephone Number	:	630-208-4172

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/26/2009

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