HOSPICE OF KANKAKEE VALLEY PALLIATIVE CLINIC (NPI# 1104906767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104906767 |
| Entity Type | Organization |
| Organization Name | HOSPICE OF KANKAKEE VALLEY PALLIATIVE CLINIC |
| Practice Address |
482 Main Street Nw Bourbonnais IL 60914-2331 |
| Practice Telephone | 8159363370 |
| Practice Fax Number | 8159363375 |
| Mailing Telephone | 8159363370 |
| Mailing Fax Number | 8159363375 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. DOROTHEA M. LAGESSE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8159363370 |
| Authorized Official Credential | MBA, HACP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315D00000X | Hospice, Inpatient | 2000420 | IL | Nursing & Custodial Care Facilities |
| Street Address |
482 MAIN STREET NW |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-2331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053685768 | Christa Hospice and Palliative Care Corp. | Hospice, Inpatient | 4103 W Shamrock Ln, Mchenry, IL 60050-8289 | 2012-02-27 |
| 1255380101 | Vista Health D/b/a St. Therese Medical Center | Hospice, Inpatient | 99 W Greenwood Ave, Waukegan, IL 60087-5136 | 2006-05-09 |
| 1700856903 | Presbyterian Homes | Hospice, Inpatient | 3200 Grant Street, Evanston, IL 60201 | 2006-01-23 |
| 1043212103 | Joliet Area Community Hospice Corporation | Hospice, Inpatient | 250 Water Stone Cir, Joliet, IL 60431-8313 | 2005-06-02 |
| 1932242518 | Blessing Hospital | Hospice, Inpatient | 936 Broadway, Quincy, IL 62301 | 2007-02-14 |
| 1053417295 | Northwestern Memorial Hospital | Hospice, Inpatient | 251 E Huron St, Chicago, IL 60611-2908 | 2006-09-15 |
| 1982657292 | Family Home Health Services, Inc. | Hospice, Inpatient | 2171 W Executive Dr, Suite 450, Addison, IL 60101-5610 | 2006-05-18 |
| City | BOURBONNAIS |
| Zip Code | 60914 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.