PRESENCE LIFE CONNECTIONS (NPI# 1770953853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770953853 |
| Entity Type | Organization |
| Organization Name | PRESENCE LIFE CONNECTIONS |
| Other Organization Name | PRESENCE LIFE CONNECTIONS PHARMACY |
| Practice Address |
670 N Convent St Bourbonnais IL 60914-1332 |
| Practice Telephone | 8159286141 |
| Practice Fax Number | 8159363238 |
| Mailing Telephone | 8159286141 |
| Mailing Fax Number | 8159363238 |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |
| Authorized Official Name | MR. MICHAEL H. BORN II (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 8159286141 |
| Authorized Official Credential | RPH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
054017069 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NADP NUMBER | 100290810 | 01 |
| Other Name | Type Code |
|---|---|
| Presence Life Connections Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396731428 | Presence Life Connections | Skilled Nursing Facility | 611 Allen Ln, St. Charles, IL 60174-1355 | 2005-09-23 |
| 1205822335 | Presence Life Connections | Skilled Nursing Facility | 400 Sullivan Rd, Aurora, IL 60506-1452 | 2005-09-23 |
| 1568458693 | Presence Life Connections | Skilled Nursing Facility | 20 Briarcliff Ln, Bourbonnais, IL 60914-1665 | 2005-09-23 |
| 1114913241 | Presence Life Connections | Skilled Nursing Facility | 4405 Highcrest Rd, Rockford, IL 61107-1452 | 2005-09-23 |
| 1477549509 | Presence Life Connections | Skilled Nursing Facility | 901 N Entrance Ave, Kankakee, IL 60901-2026 | 2005-09-23 |
| 1922094051 | Presence Life Connections | Skilled Nursing Facility | 210 Springfield Ave, Joliet, IL 60435-6589 | 2005-09-23 |
| 1023004157 | Presence Life Connections | Skilled Nursing Facility | 659 E Jefferson Street, Freeport, IL 61032-6027 | 2005-09-23 |
| 1164417218 | Presence Life Connections | Pharmacy | 670 N. Convent St., Bourbonnais, IL 60914 | 2005-09-14 |
| 1124013255 | Presence Life Connections | Skilled Nursing Facility | 3330 Maria Linden Dr, Rockford, IL 61114-5480 | 2005-09-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRESENCE LIFE CONNECTIONS | 18927 Hickory Creek Dr Ste 300, Mokena, IL 60448-8652 |
| Street Address |
670 N CONVENT ST |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-1332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| Taxonomy Code | 3336M0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Mail Order Pharmacy |
| A pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Mail order pharmacies counsel patients and caregivers (sometimes independent of the dispensing process) through telephone or email contact and provide other professional services associated with pharmaceutical care appropriate to the setting. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912523564 | Male-order Men's Health LLC | Pharmacy | 710 N. Dearborn St., Chicago, IL 60654 | 2020-06-19 |
| 1417297185 | Total Care Rx, Inc. | Pharmacy | 2480 Delta Ln, Elk Grove Village, IL 60007-6303 | 2013-02-18 |
| 1912242629 | 3 R Healthcare Products Inc | Pharmacy | 535 W Taft Dr, South Holland, IL 60473-2030 | 2012-12-06 |
| 1124379425 | Sdg Inc. | Pharmacy | 2715 Kelly Ln, Highland Park, IL 60035-1656 | 2012-09-26 |
| 1366777492 | Easy Scripts, Inc. | Pharmacy | 5244 N Sheridan Rd, Chicago, IL 60640-2513 | 2009-10-07 |
| 1043484009 | United Pharmacy Services, Inc. | Pharmacy | 5744 W Irving Park Rd, Chicago, IL 60634-3176 | 2008-04-21 |
| 1972721926 | Carthart Pharmacy | Pharmacy | 747 N La Salle Dr, Chicago, IL 60610-3589 | 2007-04-23 |
| 1386861318 | Dawn National Pharmacy | Pharmacy | 4215 Commercial Way Ct, Glenview, IL 60025 | 2007-04-19 |
| 1710021092 | Midwest Operating Engineers Health and Welfare Trust Fund | Pharmacy | 6150 Joliet Rd, Countryside, IL 60525-3956 | 2007-02-19 |
| 1598776098 | Drug Source Inc | Pharmacy | 2020 Lunt Ave, Elk Grove Village, IL 60007-5606 | 2006-08-10 |
| Find all providers with the same taxonomy | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
Please comment or provide details below to improve the information on PRESENCE LIFE CONNECTIONS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.