PEKIN MEMORIAL HOSPITAL (NPI# 1174530489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174530489 |
| Entity Type | Organization |
| Organization Name | PEKIN MEMORIAL HOSPITAL |
| Other Organization Name | PEKIN HOSPITAL SNF |
| Practice Address |
600 S 13th St Pekin IL 61554-4936 |
| Practice Telephone | 3093530756 |
| Practice Fax Number | 3093471240 |
| Mailing Telephone | 3093530756 |
| Mailing Fax Number | 3093471240 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2010-06-28 |
| Authorized Official Name | MR. KEVIN ANDREWS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3093530756 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEKIN MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0001834 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Pekin Hospital SNF | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245355411 | Pekin Memorial Hospital | Emergency Medicine | 600 So 13th Street, Pekin, IL 61554-4969 | 2007-03-20 |
| 1033130752 | Pekin Memorial Hospital | Home Health | 2934 Court St, Pekin, IL 61554-6229 | 2006-07-21 |
| 1245227479 | Pekin Memorial Hospital | General Acute Care Hospital | 600 S 13th St, Pekin, IL 61554-4936 | 2005-10-03 |
| 1306978457 | Pekin Memorial Hospital | Nurse Anesthetist, Certified Registered | 600 S 13th St, Pekin, IL 61554-4936 | 2007-03-12 |
| Street Address |
600 S 13TH ST |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-4936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245227479 | Pekin Memorial Hospital | General Acute Care Hospital | 600 S 13th St, Pekin, IL 61554-4936 | 2005-10-03 |
| 1629625769 | Mary M Smyers | Speech-Language Pathologist | 600 S 13th St, Pekin, IL 61554-4936 | 2019-08-22 |
| 1053814467 | Epss LLC - Central Series | Emergency Medicine | 600 S 13th St, Pekin, IL 61554-4936 | 2018-03-12 |
| 1538680467 | Epss LLC - Central Series | Emergency Medicine | 600 S 13th St, Pekin, IL 61554-4936 | 2017-06-30 |
| 1801345160 | Jana Huston | Nurse Practitioner | 600 S 13th St, Suite E, Pekin, IL 61554-4936 | 2016-09-28 |
| 1528514411 | Dennis Alexander Richrath | Nurse Practitioner | 600 S 13th St, Pekin, IL 61554-4936 | 2016-08-30 |
| 1609235944 | All Gastro Ltd. | Internal Medicine | 600 S 13th St, Suite J, Pekin, IL 61554-4936 | 2016-02-15 |
| 1437526852 | Jonathan Rider | Nurse Practitioner | 600 S 13th St, Suite E, Pekin, IL 61554-4936 | 2015-09-02 |
| 1144606195 | Jami Michelle Klenzman | Nurse Practitioner | 600 S 13th St, Pekin, IL 61554-4936 | 2015-07-31 |
| 1043600547 | Heidi Phillips | Nurse Anesthetist, Certified Registered | 600 S 13th St, Pekin, IL 61554-4936 | 2015-02-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194279000 | Shauna L Bivens | Nurse Practitioner | 3400 Griffin Ave., Pekin, IL 61554 | 2016-08-09 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1366750671 | Dennis Kammerer Stoller | Dentist | 1608 Broadway, Pekin, IL 61554 | 2010-09-21 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1689856312 | Pekin Supportive Living Limited Patnership | Assisted Living Facility | 1320 Executive Court, Pekin, IL 61554 | 2007-12-05 |
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1376769638 | Debra Mollie Davis | Registered Nurse | 2079 Edgewater Dr, Pekin, IL 61554 | 2007-04-17 |
| 1649308230 | Tazewell County Health Department -dental Health Center | Public Health or Welfare | 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 | 2007-03-02 |
| 1528118239 | Jerry Lee Marshall | Dentist | 135a-b Radio City Drive, North Pekin, IL 61554 | 2007-01-12 |
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| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760427827 | Hallmark House Corporation | Skilled Nursing Facility | 2501 Allentown Road, Pekin, IL 61554 | 2006-06-20 |
| 1760479505 | Unlimited Development Inc. | Skilled Nursing Facility | 1520 El Camino Drive, Pekin, IL 61554-6062 | 2005-10-05 |
| 1073148920 | Hallmark Healthcare of Pekin LLC | Skilled Nursing Facility | 2501 Allentown Rd, Pekin, IL 61554-9401 | 2020-03-10 |
| 1447404454 | Petersen Health Operations, LLC | Skilled Nursing Facility | 2220 State St, Pekin, IL 61554-3937 | 2008-11-05 |
| 1346340569 | Petersen Health Operations, LLC | Skilled Nursing Facility | 2220 State St, Pekin, IL 61554-3937 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
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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.