PROCTOR COMMUNITY HOSPITAL (NPI# 1457679581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457679581 |
| Entity Type | Organization |
| Organization Name | PROCTOR COMMUNITY HOSPITAL |
| Other Organization Name | PROCTOR HOSPITAL |
| Practice Address |
5409 N Knoxville Ave Peoria IL 61614-5069 |
| Practice Telephone | 3096911000 |
| Practice Fax Number | 3096718265 |
| Mailing Telephone | 3096724813 |
| Mailing Fax Number | 3096718265 |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2015-01-23 |
| Authorized Official Name | MS. DEBORAH R. SIMON (PRESIDENT/CEO) |
| Authorized Official Telephone | 3096725928 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | 1927324 | IL | Hospital Units |
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
0001925 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Proctor Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1518490036 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 300, Peoria, IL 61614-5021 | 2017-04-11 |
| 1033116876 | Proctor Community Hospital | General Acute Care Hospital | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2005-07-07 |
| 1134475940 | Proctor Community Hospital | Psychiatric Unit | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2012-07-30 |
| 1275859902 | Proctor Community Hospital | Substance Abuse Rehabilitation Facility | 1401 Central Ave, Bettendorf, IA 52722-6034 | 2010-04-20 |
| 1821068404 | Proctor Community Hospital | Skilled Nursing Facility | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-01-25 |
| 1487624318 | Proctor Community Hospital | Home Health | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-01-24 |
| Street Address |
5409 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116876 | Proctor Community Hospital | General Acute Care Hospital | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2005-07-07 |
| 1124637848 | Erin K Hocker | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2020-07-28 |
| 1548804925 | Susan Carrasco | Speech-Language Pathologist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-10-29 |
| 1083270938 | Christine Shaw | Hospitalist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-05-16 |
| 1043779861 | Chelsea Krejci | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-03-19 |
| 1841757077 | Abby Marie Taube | Occupational Therapist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-02-24 |
| 1164905014 | Felicia Williams-triplett | Registered Nurse | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-09-06 |
| 1871001644 | Cassie J Stone | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2018-01-16 |
| 1053854323 | Alicia Layton | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-11-18 |
| 1457706624 | Aimee Parrott | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2016-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
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| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285271684 | Bhsm Rehabilitation, LLC | Clinic/Center | 25101 N Lake Pleasant Pkwy Ste B-1340, Peoria, AZ 85383-1386 | 2019-12-04 |
| 1932146560 | Heartland of Peoria Il LLC | Clinic/Center | 5600 N Glen Elm Dr, Peoria, IL 61614-4340 | 2006-06-01 |
| 1306190780 | Physiotherapy Associates, Inc. | Clinic/Center | 7797 W Paradise Ln, Suite 140, Peoria, AZ 85382-5011 | 2012-11-06 |
| 1568791879 | Life Care Centers of America, Inc. | Clinic/Center | 20625 N Lake Pleasant Rd, Peoria, AZ 85382-9704 | 2009-12-15 |
| 1801061650 | Center for Pain Management & Rehab S. C . | Clinic/Center | 5401 N Knoxville Ave, Suite 117, Peoria, IL 61614-5095 | 2008-04-23 |
| 1285842161 | Central Illinois Rehabilitation Associates Inc Sc | Clinic/Center | 4422 N Brandywine Dr, Peoria, IL 61614-5509 | 2007-05-21 |
| 1518910363 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 218, Peoria, IL 61614-5098 | 2006-05-19 |
| 1639140833 | Frank I Russo | Clinic/Center | 5401 N Knoxville Ave, Suite 218, Peoria, IL 61614-5098 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386243020 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 2500 Williamson County Pkwy, Suite B, Marion, IL 62959-5271 | 2020-10-23 |
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1093320855 | Rci (wrs), LLC. | Clinic/Center | 17 West 580 Butterfield Road, Oakbrook Terrace, IL 60181 | 2020-09-09 |
| 1558975706 | Rci (wrs), LLC. | Clinic/Center | 370 Bank Dr, Mchenry, IL 60050-0506 | 2020-09-04 |
| 1588278741 | Rci (wrs), LLC. | Clinic/Center | 1151 S State St, Chicago, IL 60605-2304 | 2020-09-04 |
| 1487268553 | Rci (wrs), LLC. | Clinic/Center | 15 Tower Ct Ste 235, Gurnee, IL 60031-3354 | 2020-09-04 |
| 1285248351 | Rci (wrs), LLC. | Clinic/Center | 884 S Rand Rd Ste A, Lake Zurich, IL 60047-3412 | 2020-09-04 |
| 1295349355 | Rci (wrs), LLC. | Clinic/Center | 140 N Addison Ave Fl 2, Elmhurst, IL 60126-2810 | 2020-09-04 |
| 1043824287 | Rci (wrs), LLC. | Clinic/Center | 1525 E 55th St Ste 305, Chicago, IL 60615-5576 | 2020-09-04 |
| 1396359469 | Rci (wrs), LLC. | Clinic/Center | 939 W North Ave Ste 300, Chicago, IL 60642-7139 | 2020-09-04 |
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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.