Provider Demographics
NPI:1437517547
Name:DIVINE HOSPICE & PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:DIVINE HOSPICE & PALLIATIVE CARE LLC
Other - Org Name:DELTA HOSPICE & PALLIATIVE CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BINU
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-553-8500
Mailing Address - Street 1:234 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-8921
Mailing Address - Country:US
Mailing Address - Phone:630-553-8500
Mailing Address - Fax:
Practice Address - Street 1:234 GARDEN ST
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-8921
Practice Address - Country:US
Practice Address - Phone:630-553-8500
Practice Address - Fax:888-977-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty