Organization
ST PATRICK RESIDENCE
Active
Other names
St. Patrick's Residence
Organization subpart
No
Provider details
NPI number
Authorized official
SR. JEANNE HALEY (ADMINISTRATOR)
(630) 416-6565
Entity
Organization
Contact information
Practice address
1400 BROOKDALE RD, NAPERVILLE, IL 60563-2126
(630) 416-6565
(630) 416-8755
Mailing address
1400 BROOKDALE RD, NAPERVILLE, IL 60563-2126
(630) 416-6565
(630) 416-8755
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0035006
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001152
BCBSIL PROVIDER NUMBER
IL
Enumeration date
09/19/2005
Last updated
12/13/2011
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