Provena St Marys Hospital
NPI #1194982025 in Bourbonnais, Illinois
Provider Information
- NPI Number
- 1194982025
- Entity Type
- Organization
- Organization Name
- Provena St Marys Hospital
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- May 19, 2008
- Last Updated
- May 19, 2008
Practice Location
- Address
- 21 HERITAGE DRIVE
- Address 2
- SUITE 102
- City
- Bourbonnais
- State
- Illinois
- ZIP Code
- 60914
- Phone
- (815) 937-2081
Authorized Official
- Name
- MR. BARRY S LEE, LCSW CADC
- Title
- EAP SUBSTANCE ABUSE COUNSELOR
- Phone
- (815) 937-2081
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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