Provider Demographics
NPI:1689905879
Name:MERIDIAN HOSPICE, INC
Entity Type:Organization
Organization Name:MERIDIAN HOSPICE, INC
Other - Org Name:ADVOCATE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-368-5907
Mailing Address - Street 1:2311 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1225
Mailing Address - Country:US
Mailing Address - Phone:630-572-1232
Mailing Address - Fax:630-368-5912
Practice Address - Street 1:303 N HERSHEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-3576
Practice Address - Country:US
Practice Address - Phone:309-888-0930
Practice Address - Fax:309-268-5960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERIDIAN HOSPICE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-27
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2000123251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based