ILLINOIS VALLEY COMMUNITY HOSPITAL (NPI# 1205469483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205469483 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Practice Address |
1403 Sixth Street Peru IL 61354 |
| Practice Telephone | 8157803834 |
| Practice Fax Number | 8157803833 |
| Mailing Telephone | 8157803834 |
| Mailing Fax Number | 8157803833 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Authorized Official Name | JANE FRIEL (COMPLIANCE OFFICER AND MANAGED CARE) |
| Authorized Official Telephone | 8157803544 |
| Is Organization Subpart | Y |
| Parent Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WW0000X |
Registered Nurse Specialization: Wound Care |
Nursing Service Providers | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| IVCH Wound & Hyperbaric Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659744167 | Illinois Valley Community Hospital | Clinic/Center | 920 West St Ste 117, Peru, IL 61354-2765 | 2015-11-05 |
| 1114299583 | Illinois Valley Community Hospital | Clinic/Center | 815 N Orlando Smith St, Oglesby, IL 61348-9692 | 2012-02-01 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| 1982789582 | Illinois Valley Community Hospital | General Acute Care Hospital | 925 West Street, Illinois Valley Community Hospital, Peru, IL 61354-2799 | 2006-10-25 |
| 1902800535 | Illinois Valley Community Hospital | Durable Medical Equipment & Medical Supplies | 925 West St, Peru, IL 61354-2757 | 2005-06-10 |
| 1124596283 | Illinois Valley Community Hospital | Clinic/Center | 310 Walnut St, Peru, IL 61354-1946 | 2018-11-07 |
| 1386005395 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2016-03-18 |
| 1306207311 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2016-03-18 |
| 1578929816 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2015-12-31 |
| 1851764369 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 311, Peru, IL 61354-2763 | 2015-11-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ILLINOIS VALLEY COMMUNITY HOSPITAL | 925 West St, Peru, IL 61354-2757 |
| Street Address |
1403 SIXTH STREET |
| City | PERU |
| State | IL |
| Zip Code | 61354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1689228322 | Zhong Xue | Dentist | 5301 Il-251, Ste A, Peru, IL 61354 | 2019-07-31 |
| 1003281668 | Christopher Shane Smith | Physical Therapist | 1400 Midtown Road, Peru, IL 61354 | 2015-12-08 |
| 1770823197 | Muscle Pain Clinic Inc | Chiropractor | 4231 Progress Blvd Ste 4, Peru, IL 61354 | 2013-02-21 |
| 1306194451 | Vijaya Lakshmi Bathina | Dentist | 5301 Route 251, Peru, IL 61354 | 2012-08-21 |
| 1225305634 | Walgreens | Point of Service | 1033 Shooting Park Road, Peru, IL 61354 | 2011-11-30 |
| 1811293574 | Charles Riva | Physical Therapist | 4461 N. Progress Blvd., Peru, IL 61354 | 2011-01-28 |
| 1932403896 | Emerging Vision, Inc | Eyewear Supplier (Equipment, not the service) | 3940 Route 251, Peru Mall Suite F-1, Peru, IL 61354 | 2011-01-06 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| 1952634982 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1222 Shooting Park Rd, #104, Peru, IL 61354 | 2009-09-09 |
| Find all providers in zip 61354 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336755941 | Sacred Heart Clinic of Lasalle Inc. | Clinic/Center | 920 West St Ste 214, Peru, IL 61354-2769 | 2020-09-18 |
| 1124596283 | Illinois Valley Community Hospital | Clinic/Center | 310 Walnut St, Peru, IL 61354-1946 | 2018-11-07 |
| 1427196476 | Certified Surgeons, Inc. | Clinic/Center | 1 S Broadway, Peru, IN 46970-2231 | 2007-02-02 |
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|---|---|---|---|---|
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| 1316563000 | Milestones Behavioral Health Services | Clinic/Center | 939 Georgetowne Dr, O Fallon, IL 62269-3414 | 2020-06-18 |
| 1689299257 | Precision Immediate Care and Medical Center, LLC | Clinic/Center | 3520 W North Ave, Stone Park, IL 60165-1042 | 2020-06-10 |
| 1013536663 | Katrina Lake Md LLC | Clinic/Center | 18503 Bellamy Rd, Country Club Hills, IL 60478-5279 | 2020-04-14 |
| 1558995779 | Signature Medical Clinic LLC | Clinic/Center | 2020 Dean St Ste G, St Charles, IL 60174-1665 | 2020-02-26 |
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1104460922 | Infinite Care Home Physicians LLC | Clinic/Center | 6044 N Nassau Ave, Chicago, IL 60631-2649 | 2019-11-05 |
| 1962051607 | Wilkes Post Acute Care Inc | Clinic/Center | 400 W 76th St Ste 303, Chicago, IL 60620-1640 | 2019-09-05 |
| 1114573672 | Immediate Home Care Physicians Services Inc | Clinic/Center | 10516 S Roberts Rd Ste A2, Palos Hills, IL 60465-1934 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
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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.