PROCTOR COMMUNITY HOSPITAL (NPI# 1134475940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134475940 |
| Entity Type | Organization |
| Organization Name | PROCTOR COMMUNITY HOSPITAL |
| Other Organization Name | PROCTOR HOSPITAL |
| Practice Address |
5409 N Knoxville Ave Peoria IL 61614-5069 |
| Practice Telephone | 3096911000 |
| Practice Fax Number | 3096718265 |
| Mailing Telephone | 3096724813 |
| Mailing Fax Number | 3096718265 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2015-01-23 |
| Authorized Official Name | MS. DEBORAH R. SIMON (PRESIDENTCEO) |
| Authorized Official Telephone | 3096725928 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273R00000X | Psychiatric Unit | 2087309 | IL | Hospital Units |
| Y | 273R00000X | Psychiatric Unit | 0001925 | IL | Hospital Units |
| Other Name | Type Code |
|---|---|
| Proctor Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1518490036 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 300, Peoria, IL 61614-5021 | 2017-04-11 |
| 1033116876 | Proctor Community Hospital | General Acute Care Hospital | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2005-07-07 |
| 1457679581 | Proctor Community Hospital | Rehabilitation, Substance Use Disorder Unit | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2010-05-13 |
| 1275859902 | Proctor Community Hospital | Substance Abuse Rehabilitation Facility | 1401 Central Ave, Bettendorf, IA 52722-6034 | 2010-04-20 |
| 1821068404 | Proctor Community Hospital | Skilled Nursing Facility | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-01-25 |
| 1487624318 | Proctor Community Hospital | Home Health | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-01-24 |
| Street Address |
5409 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116876 | Proctor Community Hospital | General Acute Care Hospital | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2005-07-07 |
| 1124637848 | Erin K Hocker | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2020-07-28 |
| 1548804925 | Susan Carrasco | Speech-Language Pathologist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-10-29 |
| 1083270938 | Christine Shaw | Hospitalist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-05-16 |
| 1043779861 | Chelsea Krejci | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-03-19 |
| 1841757077 | Abby Marie Taube | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-02-24 |
| 1164905014 | Felicia Williams-triplett | Registered Nurse | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-09-06 |
| 1871001644 | Cassie J Stone | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-01-16 |
| 1053854323 | Alicia Layton | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-11-18 |
| 1457706624 | Aimee Parrott | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275583155 | Methodist Medical Center of Illinois | Psychiatric Unit | 221 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1740570316 | Robert Young Center | Psychiatric Unit | 4200 6th Ave, Rock Island, IL 61201-2109 | 2011-04-15 |
| 1669704326 | Isaac Ray Center At Cermak | Psychiatric Unit | 3159 N Seminary #301, Chicago, IL 60657 | 2010-02-05 |
| 1316115223 | 394567 D North | Psychiatric Unit | 4200 North Oak Park Ave, Chicago, IL 60634-1417 | 2008-02-13 |
| 1508034414 | 395061 Med Eval | Psychiatric Unit | 4200 North Oak Park Avenue, Chicago, IL 60634-1417 | 2008-02-13 |
| 1952425076 | Elgin Mental Health Center William White 4585 | Psychiatric Unit | 750 S. State St., Elgin, IL 60123-7692 | 2007-03-16 |
| 1932251766 | Families and Adolescents In Recovery, Inc. | Psychiatric Unit | 2010 E Algonquin Rd, Suite # 203-207, Schaumburg, IL 60173-4185 | 2007-01-18 |
| 1003976713 | Presence Central and Suburban Hospitals Network | Psychiatric Unit | 333 N. Madison St., Joliet, IL 60435-6595 | 2006-12-11 |
| 1871678334 | Kindred Thc Chicago, LLC | Psychiatric Unit | 2544 W Montrose Ave, Chicago, IL 60618 | 2006-10-25 |
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| 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.