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Provena Home Health Inc
Home Infusion Agency in Boubonnais, Illinois
NPI 1720037120

Provena Home Health Inc is a Home Infusion Agency based in Frankfort, IL. Provena Home Health Inc practices in Boubonnais, IL. The NPI Number for Provena Home Health Inc is 1720037120 and holds a License No. 1010262 (Illinois).

The current practice location address for Provena Home Health Inc is 179 East Bethel Drive, Boubonnais, IL and can be reached out via phone at 815-937-2475 and via fax at 815-936-5155.

Location: 179 East Bethel Drive, Boubonnais, IL, 60423-8334
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720037120
Provider Name
Provena Home Health Inc
Credential
Provider Entity Type
Organization
Address
179 East Bethel Drive, Boubonnais, IL, 60423-8334
Phone Number
815-937-2475
Fax Number
815-936-5155
Provider Enumeration Date
05/10/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
04623560 01 IL BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
179 East Bethel Drive
City
Boubonnais
State
Illinois
Zip
60914-1456
Phone Number
815-937-2475
Fax Number
815-936-5155
person
Provider Business Mailing Address Details
Address
179 East Bethel Drive
City
Boubonnais
State
Illinois
Zip
60914-1456
Phone Number
815-937-2475
Fax Number
815-936-5155
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Infusion
Speciality
-
Taxonomy
251F00000X
License No.
1010262 (Illinois)
Definition
Definition to come...
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