Provena Care at Home

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

11580037 Issued in IL

Legal business name

PROVENA CARE AT HOME

Doing business as

Provena Home Medical Equipment

Practice address

1100 Essington Road
Joliet, IL 60435-8429

Phone

(815) 773-7868

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Margaret C Gleason, RN MSN

Title

President Ceo

Phone

(815) 806-2364

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Provena Home Medical Equipment Doing business as

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386689610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9223 WEST ST FRANCIS ROAD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "60423",
            "telephone_number": "815-806-2300",
            "fax_number": "815-806-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ESSINGTON ROAD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358429",
            "telephone_number": "815-773-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVENA CARE AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "815-806-2364",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN MSN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "11580037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "9923629",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provena Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James D Pritz, R.PH.
• Thomas Pritz, PHARMD, RPH
• Promises of Recovery
• Propensity ABA Services, LLC
• Anthony E Proske, MD
• Provena Care at Home
• Provena Home Health Inc (Provena Home Infusion Joliet)
• Gianna Marie Prucha, PA
• Bianca Pruitt, RN,MSN,DNP,CCM
• Essie Pearllena Pruitt, LCSW

• Durable Medical Equipment & Medical Supplies in Joliet, IL
• Providers in Joliet, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.