Provider Demographics
NPI:1891762324
Name:PEACEFUL NITES INC
Entity Type:Organization
Organization Name:PEACEFUL NITES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RCP
Authorized Official - Phone:815-729-2700
Mailing Address - Street 1:2541 DIVISION ST
Mailing Address - Street 2:STE 102
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8737
Mailing Address - Country:US
Mailing Address - Phone:815-729-2700
Mailing Address - Fax:815-729-4500
Practice Address - Street 1:2541 DIVISION ST
Practice Address - Street 2:STE 102
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8737
Practice Address - Country:US
Practice Address - Phone:815-729-2700
Practice Address - Fax:815-729-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932025OtherBCBS
IL09932025OtherBCBS
IL4618160001Medicare ID - Type Unspecified