Provider Demographics
NPI:1679660153
Name:LEXINGTON HOSPICE SERVICES LLC
Entity Type:Organization
Organization Name:LEXINGTON HOSPICE SERVICES LLC
Other - Org Name:ST CROIX HOSPICE LOMBARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-328-6914
Mailing Address - Street 1:665 W NORTH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-1134
Mailing Address - Country:US
Mailing Address - Phone:630-748-3700
Mailing Address - Fax:630-748-3701
Practice Address - Street 1:665 W NORTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-1134
Practice Address - Country:US
Practice Address - Phone:630-748-3652
Practice Address - Fax:630-748-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002467251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid