Organization
NORTHERN ILLINOIS HOSPICE ASSOCIATION
Active
Other names
Northern Illinois Palliative Care, Northern Illinois Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA J NOVAK (CHIEF EXECUTIVE OFFICER)
(815) 398-0500
Entity
Organization
Contact information
Practice address
4751 HARRISON AVE, ROCKFORD, IL 61108-7929
(815) 398-0500
(815) 398-0588
Mailing address
4751 HARRISON AVE, ROCKFORD, IL 61108-7929
(815) 398-0500
(815) 398-0588
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2000313
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9579
BLUECROSS/BLUESHIELD PROV
ID
Enumeration date
07/13/2005
Last updated
04/02/2025
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