Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provena St Marys Hospital

Organization Clinical Social Worker · NPI 1194982025

Provena St Marys Hospital is a Clinical Social Worker in Bourbonnais, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008

Practice location Address checks out

21 Heritage Dr Ste 102
Bourbonnais, IL 60914
Phone: (815) 937-2081
Fax: (815) 937-8798
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149006455 (IL)

Record details

NPI number1194982025
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Barry Lee — Eap Substance Abuse Counselor · (815) 937-2081
NPI enumeratedMay 19, 2008
Last updated in NPPESMay 19, 2008
Mailing address21 Heritage Drive, Suite 102, Bourbonnais, IL 60914

Other providers in Bourbonnais