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Organization
PRESENCE ST. MARY HOSPITAL
Active
Organization
PRESENCE ST. MARY HOSPITAL
Active
Other names
HEART FAILURE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MELVONNE JONES (MGR, CREDENTIALING)
(630) 914-2417
Entity
Organization
Contact information
Practice address
500 W COURT ST, KANKAKEE, IL 60901-3661
(815) 937-2200
(815) 937-2258
Mailing address
1000 REMINGTON BLVD, SUITE 100, BOLINGBROOK, IL 60440-5114
(630) 914-2417
(630) 914-2499
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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