PEKIN MEMORIAL HOSPITAL (NPI# 1245355411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245355411 |
| Entity Type | Organization |
| Organization Name | PEKIN MEMORIAL HOSPITAL |
| Other Organization Name | PEKIN HOSPITAL |
| Practice Address |
600 So 13th Street Pekin IL 61554-4969 |
| Practice Telephone | 3093530406 |
| Practice Fax Number | 3093471240 |
| Mailing Telephone | 3093530406 |
| Mailing Fax Number | 3093471240 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2012-07-06 |
| Authorized Official Name | GARY JEPSON (CEO) |
| 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 | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0001834 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pekin Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1174530489 | Pekin Memorial Hospital | Skilled Nursing Facility | 600 S 13th St, Pekin, IL 61554-4936 | 2006-08-01 |
| Street Address |
600 SO 13TH STREET |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-4969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679698054 | Pekin Hospital | Nurse Anesthetist, Certified Registered | 600 So 13th Street, Pekin, IL 61554 | 2007-03-21 |
| 1437274602 | Pekin Hospital | General Acute Care Hospital | 600 So 13th Street, Pekin, IL 61554 | 2007-03-20 |
| 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 |
| Find all providers in zip 61554 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134213051 | Timothy Voirin | Emergency Medicine | 600 S 13th St, Pekin, IL 61554-4936 | 2006-10-03 |
| 1306938675 | Nels Calvert | Emergency Medicine | 600 S 13th St, Pekin, IL 61554-4936 | 2006-09-28 |
| 1669588869 | Joseph Jeffrey Krug | Emergency Medicine | 600 S 13th St, Pekin, IL 61554-4936 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033760715 | Michael James Doolin | Emergency Medicine | 1338 S Clinton St, Chicago, IL 60607-5037 | 2019-09-24 |
| 1578091971 | The Board of Trustee for The University of Illinois | Emergency Medicine | 10000 West O'hare, Terminal 2, Chicago, IL 60660-0508 | 2017-05-30 |
| 1669712808 | Kathryn Theresa Pajak | Emergency Medicine | 5659 S Oak Park Ave, Chicago, IL 60638-3227 | 2013-02-26 |
| 1174832976 | Craig William Dean | Emergency Medicine | 155 N Harbor Dr Apt 309, Chicago, IL 60601-7386 | 2010-09-28 |
| 1770809881 | King, Ltd | Emergency Medicine | 9332 S Vanderpoel Ave, Chicago, IL 60643-5852 | 2010-04-14 |
| 1306098231 | Robert Dietz Tetik | Emergency Medicine | 2272 95th St Ste 106, Naperville, IL 60564-8942 | 2008-10-22 |
| 1831384643 | Primus Trauma Care LLC | Emergency Medicine | 1304 Franklin Avenue, Normal, IL 61761 | 2007-09-14 |
| 1396879268 | Nanci A Cherry | Emergency Medicine | 7419 Bell Harbour Dr, Rockford, IL 61114-6600 | 2007-03-15 |
| 1972609782 | Jennifer Lynn Webb | Emergency Medicine | 15730 Robert Louis Dr, Plainfield, IL 60544-2146 | 2006-09-16 |
| 1073629374 | Stuart Hickerson | Emergency Medicine | 12528 Sr 78, Havana, IL 62644-6866 | 2006-08-21 |
| 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.