Organization
REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME
Active
Other names
Providence Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA ZANDSTRA (VP OF OPERATIONS)
(708) 342-8100
Entity
Organization
Contact information
Practice address
14301 INDEPENDENCE WAY, HOMER GLEN, IL 60491-7210
(708) 331-0400
(708) 877-4818
Mailing address
14301 INDEPENDENCE WAY, HOMER GLEN, IL 60491-7210
(800) 509-2800
(708) 877-4818
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2002251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002251
HOSPICE LICENSE NUMBER
IL
Enumeration date
07/20/2005
Last updated
10/01/2025
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