- Enrollment id
- O20220420001055
- Enrollment state
- IL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1417612318
- Multiple npi flag
- N
- Ccn
- 141525
- Associate id
- 8325435456
- Organization name
- ADDUS HOSPICE OF ILLINOIS, LLC
- Doing business as name
- JOURNEYCARE
- Incorporation date
- 2021-10-15
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 405 LAKE ZURICH RD
- Address line 2
- STE 100
- City
- BARRINGTON
- State
- IL
- Zip code
- 600103141