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Presence Hospitals Prv
Hematology & Oncology Physician in Bourbonnais, Illinois
NPI 1215141627

Presence Hospitals Prv is a Hematology & Oncology Physician based in Kankakee, IL and is specialized in Hematology & Oncology. Presence Hospitals Prv practices in Bourbonnais, IL. The NPI Number for Presence Hospitals Prv is 1215141627 and holds a License No. 0004879 (Illinois).

The current practice location address for Presence Hospitals Prv is 100 Provena Way, Bourbonnais, IL and can be reached out via phone at 815-937-8780 and via fax at 815-937-8241.

Location: 100 Provena Way, Bourbonnais, IL, 60901-3661
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215141627
Provider Name
Presence Hospitals Prv
Credential
Provider Entity Type
Organization
Address
100 Provena Way, Bourbonnais, IL, 60901-3661
Phone Number
815-937-8780
Fax Number
815-937-8241
Provider Enumeration Date
05/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0004621885 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
100 Provena Way
City
Bourbonnais
State
Illinois
Zip
60914-4796
Phone Number
815-937-8780
Fax Number
815-937-8241
person
Provider Business Mailing Address Details
Address
100 Provena Way
City
Bourbonnais
State
Illinois
Zip
60914-4796
Phone Number
815-937-8780
Fax Number
815-937-8241
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
207RH0003X
License No.
0004879 (Illinois)
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
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