# PROVENA HOME HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVENA HEALTH
- **Other names:** Provena Home Health Inc Waukegan
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477502672
- **Legal business name:** PROVENA HEALTH
- **Authorized official:** MRS. MARGARET C GLEASON RN MSN (PRESIDENT CEO)
- **Authorized official phone:** (815) 806-2364

## Contact information

- **Practice address:** 222 SOUTH GREENLEAF AVE, SUITE 103, GURNEE, IL 60031-5705
- **Practice address phone:** (847) 360-7660
- **Practice address fax:** (847) 360-8411
- **Mailing address:** 9223 WEST ST FRANCIS ROAD, FRANKFORT, IL 60423-8334
- **Mailing address phone:** (815) 806-2300
- **Mailing address fax:** (815) 806-0409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1010261 | IL | Yes |

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 09/16/2009