Organization
LIFELINE NURSING AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WHISTLER (OWNER)
(224) 595-7221
Entity
Organization
Contact information
Practice address
5119 BRIARWOOD RD, WOODSTOCK, IL 60098-7626
(224) 888-8181
Mailing address
5119 BRIARWOOD RD, WOODSTOCK, IL 60098-7626
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
4000556
IL
251E00000X
Home Health Agency
HF114153
IL
251J00000X
Nursing Care Agency
Primary
4000556
IL
251J00000X
Nursing Care Agency
HF114153
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073008363
BLUE CROSS BLUE SHIELD OF IL
IL
01
—
4000556
ILLINOIS DEPT OF PUBLIC HEALTH
IL
Enumeration date
06/28/2018
Last updated
09/02/2021
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