Organization
MARIANJOY AT PROVIDENCE DOWNER GROVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELYN BARNES (PFS MANAGER)
(630) 909-7378
Entity
Organization
Contact information
Practice address
3450 SARATOGA AVE, DOWNERS GROVE, IL 60515-1141
(630) 909-7370
(630) 909-7371
Mailing address
27 W 171 ROOSEVELT ROAD, WHEATON, IL 60187-1141
(630) 909-7378
(630) 909-7371
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50425
BLUE CROSS BLUE SHIELD ILLINOIS
IL
Enumeration date
04/13/2009
Last updated
02/11/2013
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