PETERSEN HEALTH OPERATIONS, LLC (NPI# 1235176504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235176504 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH OPERATIONS, LLC |
| Other Organization Name | FONDULAC REHABILITATION & HEALTH CARE CENTER |
| Practice Address |
901 Illini Dr East Peoria IL 61611-1840 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 3096946446 |
| Practice Fax Number | 3096948705 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MARK B. PETERSEN (GENERAL MANAGER) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0047472 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Fondulac Rehabilitation & Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952555658 | Petersen Health Operations, LLC | Skilled Nursing Facility | Rt 1 Ferrel Rd, Rosiclaire, IL 62982 | 2008-11-07 |
| 1043464746 | Petersen Health Operations, LLC | Skilled Nursing Facility | 995 State Rt 127 S, Jonesboro, IL 62952 | 2008-11-07 |
| 1336393347 | Petersen Health Operations, LLC | Skilled Nursing Facility | 418 South Memorial Drive, Newman, IL 61942 | 2008-11-05 |
| 1356441539 | Petersen Health Operations, LLC | Skilled Nursing Facility | 900 N Market St, Watseka, IL 60970-1048 | 2006-09-25 |
| 1710922117 | Petersen Health Operations, LLC | Skilled Nursing Facility | 1083 Ozark Care Dr, Box 270, Osage Beach, MO 65065-3016 | 2006-06-19 |
| 1225071442 | Petersen Health Operations, LLC | Nursing Facility/Intermediate Care Facility | 107 N Watkins Street, Cisne, IL 62823 | 2006-06-14 |
| 1285672766 | Petersen Health Operations, LLC | Skilled Nursing Facility | 1400 E Washington St, Pittsfield, IL 62363-9586 | 2006-06-04 |
| 1497712228 | Petersen Health Operations, LLC | Skilled Nursing Facility | 1925 S Main St, Bloomington, IL 61704-7301 | 2006-04-26 |
| 1376509380 | Petersen Health Operations, LLC | Nursing Facility/Intermediate Care Facility | 520 Fabyan Parkway, Batavia, IL 60510 | 2006-04-26 |
| 1841444601 | Petersen Health Operations, LLC | Skilled Nursing Facility | 400 W Grant St, Macomb, IL 61455-2867 | 2008-11-06 |
| Street Address |
901 ILLINI DR |
| City | EAST PEORIA |
| State | IL |
| Zip Code | 61611-1840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548414550 | Petersen Health Operations | Skilled Nursing Facility | 901 Illini Dr, East Peoria, IL 61611-1840 | 2008-11-05 |
| 1629231840 | Carol Ruch Wylie | Speech-Language Pathologist | 901 Illini Dr, East Peoria, IL 61611-1840 | 2008-07-08 |
| 1538287933 | Julie C Bosley | Occupational Therapist | 901 Illini Dr, East Peoria, IL 61611-1840 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548736390 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 133 Spinder Drive Ste 4015, East Peoria, IL 61611 | 2018-10-19 |
| 1083128474 | Abc Counseling & Family Services | Clinic/Center | 111 W. Washington St., Suite 410b, East Peoria, IL 61611 | 2017-11-22 |
| 1386162253 | Cheryl Denise Hagedorn | Speech-Language Pathologist | 306 Eckley Avenue, East Peoria, IL 61611 | 2017-08-31 |
| 1710342076 | Rebecca Uthe | Physical Therapist | 901 Illini Drive, East Peoria, IL 61611 | 2015-12-30 |
| 1669812103 | Christopher Webb | Dentist | 360 West Washington Street, East Peoria, IL 61611 | 2013-06-28 |
| 1386985380 | Dental Professionals of Illinois, P.C. | Dentist | 368 W. Washington St., East Peoria, IL 61611 | 2013-03-15 |
| 1730432675 | Synergy Healthcare Physical Medicine Sc | Chiropractor | 350 Cimmeron Drive, East Peoria, IL 61611 | 2012-10-16 |
| 1508122029 | Daniel Benjamin Gans | Radiology | 111 Oakwood Rd, East Peoria, IL 61611 | 2012-04-10 |
| 1326288390 | Sara Sabry Fouad Rizk | Pharmacist | 2540 East Washington Street, East Peoria, IL 61611 | 2009-03-03 |
| 1356466007 | Tazwood Mental Health Center, Inc. | Counselor | 111 W. Washington Street, Suite 230, East Peoria, IL 61611 | 2007-03-20 |
| Find all providers in zip 61611 | ||||
| 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 |
|---|---|---|---|---|
| 1699810093 | East Peoria Gardens Healthcare | Skilled Nursing Facility | 1910 Springfield Rd, East Peoria, IL 61611-4343 | 2007-02-21 |
| 1548742463 | Generations At Riverview, LLC | Skilled Nursing Facility | 500 Centennial Dr, East Peoria, IL 61611-4912 | 2018-09-06 |
| 1548414550 | Petersen Health Operations | Skilled Nursing Facility | 901 Illini Dr, East Peoria, IL 61611-1840 | 2008-11-05 |
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|---|---|---|---|---|
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| 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 |
| Find all providers with the same taxonomy | ||||
| City | EAST PEORIA |
| Zip Code | 61611 |
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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.