Organization
PRESENCE SAINT JOSEPH HOSPITAL-ELGIN
Active
Other names
Heart Failure Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MELVONNE JONES (CREDENTIALING MANAGER)
(630) 914-2417
Entity
Organization
Contact information
Practice address
77 N AIRLITE ST, ELGIN, IL 60123-4912
(847) 695-3200
Mailing address
1000 REMINGTON BLVD, STE 100, BOLINGBROOK, IL 60440-5114
(630) 914-2417
(630) 914-2499
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008175
IL
363LA2200X
Adult Health Nurse Practitioner
209-006950
IL
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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