Presence Hospitals PRV

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

0004879 Issued in IL

Legal business name

PRESENCE HOSPITALS PRV

Doing business as

Presence St. Mary's Cancer Center

Practice address

100 Provena Way
Suite 103
Bourbonnais, IL 60914-4796

Phone

(815) 937-8780

Fax

(815) 937-8241

NPI assigned

May 9, 2007

Organization subpart

Yes

Parent organization

PRESENCE HOSPITALS - PRVAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony J. Filer

Title

System, Chief Financial Officer

Phone

(708) 478-7674

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Presence St. Mary's Cancer Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Mercy Ctr Health Phys E

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Presence Hospitals PRV

  dba Presence Saint Joseph Medical Center - Ped/Endo Clinic

  • Pediatric Endocrinology Physician
  • Joliet, IL
  • NPI 1659740033
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Margaret Comfort, PA

  • Physician Assistant
  • Bourbonnais, IL
  • NPI 1033245683
  NPD (past)
• David J Debono, MD

  • Hematology & Oncology Physician
  • Rochester Hills, MI
  • NPI 1588688840
  NPD (past)
• Victor Rostapshov

  • Hematology (Internal Medicine) Physician
  • Spokane Valley, WA
  • NPI 1548315435
  NPD (past)
• Leno Thomas, MD

  • Hematology & Oncology Physician
  • Poughkeepsie, NY
  • NPI 1295755262
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1215141627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013661",
            "telephone_number": "815-937-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROVENA WAY",
            "address_2": "SUITE 103",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144796",
            "telephone_number": "815-937-8780",
            "fax_number": "815-937-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE HOSPITALS PRV",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESENCE HOSPITALS - PRV",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "FILER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SYSTEM, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "708-478-7674"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "0004879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004621885",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence St. Mary's Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Potts
• Christopher Thomas Powell, D.D.S.
• Kristen Powell
• Prairie River Counseling and Consulting, LLC
• Prairieview GYN LLC
• Presence Life Connections (Presence Our Lady of Victory Nursing Home)
• Prime Healthcare Home Care LLC
• Provena Imaging Services Inc (Provena Health Center for Diagnostic Imaging)
• Provena St Marys Hospital
• Pulmonary & Critical Care Associates of Kankakee LTD

• Hematology & Oncology Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.