PETERSEN HEALTH CARE II, INC. (NPI# 1376794511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376794511 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH CARE II, INC. |
| Other Organization Name | SULLIVAN REHABILITATION & HEALTH CARE CENTER |
| Practice Address |
11 Hawthorne Ln Sullivan IL 61951-9490 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 2177284327 |
| Mailing Telephone | 3096918113 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2020-05-19 |
| Authorized Official Name | MARK B. PETERSEN (MANAGER) |
| Authorized Official Telephone | 3096895880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0046425 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Sullivan Rehabilitation & Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598918385 | Petersen Health Care II, Inc. | Assisted Living Facility | 20 Courtyard Boulevard, Sullivan, IL 61951-7001 | 2008-10-24 |
| 1194781807 | Petersen Health Care II, Inc. | Skilled Nursing Facility | 605 E Church St, Kewanee, IL 61443-3503 | 2006-04-21 |
| 1811953532 | Petersen Health Care II, Inc. | Skilled Nursing Facility | 715 E Raymond Rd, Watseka, IL 60970-9730 | 2006-04-21 |
| Street Address |
11 HAWTHORNE LN |
| City | SULLIVAN |
| State | IL |
| Zip Code | 61951-9490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417913583 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2006-04-26 |
| 1386277556 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2020-02-17 |
| 1942708581 | Ashley Neikirk | Speech-Language Pathologist | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2018-01-29 |
| 1306274618 | Danielle Linder | Speech-Language Pathologist | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497104558 | Laura Ellis | Speech-Language Pathologist | 1 Masonic Way, Sullivan, IL 61951 | 2016-06-09 |
| 1134561665 | Murray Chiropractic and Acupuncture, LLC | Chiropractor | 221 N Anderson St, Sullivan, IL 61951-1001 | 2013-07-25 |
| 1427450220 | Harley Chiropractic, LLC | Chiropractor | 221 N Anderson St, Sullivan, IL 61951-1001 | 2014-09-23 |
| 1104822568 | Patricia E Carr | Nurse Practitioner | 1220 W Jackson St, Sullivan, IL 61951-1032 | 2005-06-21 |
| 1396789590 | Healthcom, Inc | Emergency Response System Companies | 1600 W Jackson St, Sullivan, IL 61951-1066 | 2006-06-16 |
| 1598275646 | Janice Althoff | Speech-Language Pathologist | 910 N Graham St, Sullivan, IL 61951-1114 | 2017-10-03 |
| 1134639289 | Anne Margaret Osthoff | Speech-Language Pathologist | 910 N Graham St, Sullivan, IL 61951-1114 | 2017-10-03 |
| 1891857447 | William Earl Alwerdt | Dentist | 110 N Hamilton St, Sullivan, IL 61951-1405 | 2006-12-13 |
| 1548511819 | Cindi L Reed | Pharmacist | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2012-09-27 |
| 1306466263 | Reed Pharmacies, LLC | Family Medicine | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2020-04-21 |
| Find all providers in zip 61951 | ||||
| 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 |
|---|---|---|---|---|
| 1568419232 | Sullivan Operations, LLC | Skilled Nursing Facility | 875 Dunsford Dr, Sullivan, MO 63080-1238 | 2006-05-28 |
| 1417913583 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2006-04-26 |
| 1710952866 | Sullivan Health & Living Center, Inc. | Skilled Nursing Facility | 325 W Northwood Dr, Sullivan, IN 47882-7515 | 2006-02-22 |
| 1194703702 | Petersen Health Care Vii LLC | Skilled Nursing Facility | 1 Masonic Way, Sullivan, IL 61951-9467 | 2006-01-04 |
| 1811984644 | Eastview Terrace | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2005-10-06 |
| 1063419505 | Community Care Ctr of Sullivan, Inc | Skilled Nursing Facility | 940 Mattox Dr, Sullivan, MO 63080-2364 | 2005-06-30 |
| 1063045227 | Eastview Hco, LLC | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2020-02-17 |
| 1386277556 | Sullivan Hco, LLC | Skilled Nursing Facility | 11 Hawthorne Ln, Sullivan, IL 61951-9490 | 2020-02-17 |
| 1609027846 | Petersen Health Care, Inc | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2008-10-07 |
| 1013193903 | Witham Memorial Hospital | Skilled Nursing Facility | 325 W Northwood Dr, Sullivan, IN 47882-7515 | 2008-01-10 |
| Find all providers in SULLIVAN | ||||
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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.