Provider Demographics
NPI:1124101308
Name:UNIVERSITY OF ST. FRANCIS
Entity type:Organization
Organization Name:UNIVERSITY OF ST. FRANCIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH AND WELLNESS CEN
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARAGOS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP
Authorized Official - Phone:815-740-3815
Mailing Address - Street 1:500 WILCOX ST
Mailing Address - Street 2:NURSING
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6169
Mailing Address - Country:US
Mailing Address - Phone:815-740-3815
Mailing Address - Fax:815-740-4243
Practice Address - Street 1:311 N OTTAWA ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4048
Practice Address - Country:US
Practice Address - Phone:815-740-3815
Practice Address - Fax:815-740-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTAX ID