THE CARLE FOUNDATION HOSPITAL (NPI# 1619034659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619034659 |
| Entity Type | Organization |
| Organization Name | THE CARLE FOUNDATION HOSPITAL |
| Other Organization Name | CARLE FOUNDATION REHAB UNIT |
| Practice Address |
611 W Park St Urbana IL 61801-2500 |
| Practice Telephone | 2173262911 |
| Practice Fax Number | 2173448047 |
| Mailing Telephone | 2173262911 |
| Mailing Fax Number | 2173448047 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2013-07-02 |
| Authorized Official Name | JAMES LEONARD (CEO) |
| Authorized Official Telephone | 2173833221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | 0003798 | IL | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHLINK PROV ID | 113326 | 01 | |
| HAMP PROVIDER ID | 4117 | 01 | |
| BLUE CROSS PROVIDER ID | 203 | 01 | |
| PERSONALCARE PROV ID | 7216 | 01 |
| Other Name | Type Code |
|---|---|
| Carle Foundation Rehab Unit | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053711770 | The Carle Foundation Hospital | Durable Medical Equipment & Medical Supplies | 810 W Anthony Dr., Urana, IL 61802-7431 | 2014-08-29 |
| 1437275328 | The Carle Foundation Hospital | Clinic/Center | 5731 Park Dr, Charleston, IL 61920-9466 | 2007-03-22 |
| 1053378349 | The Carle Foundation Hospital | Durable Medical Equipment & Medical Supplies | 200 Lerna Rd S Ste 101, Mattoon, IL 61938-9301 | 2006-04-28 |
| 1457347668 | The Carle Foundation Hospital | Pharmacy | 221 N Broadway Ave Ste 100, Urbana, IL 61801-2747 | 2005-09-22 |
| 1891780615 | The Carle Foundation Hospital | Home Health | 1813 W Kirby Ave, Champaign, IL 61821-5410 | 2005-09-19 |
| 1053932426 | The Carle Foundation Hospital | Pharmacy | 221 N Broadway Ave Ste 100, Urbana, IL 61801-2748 | 2020-04-27 |
| 1134765712 | The Carle Foundation Hospital | Durable Medical Equipment & Medical Supplies | 611 W Park St, Urbana, IL 61801-2529 | 2019-11-19 |
| 1821582131 | The Carle Foundation Hospital | Pharmacy | 206a W Anthony Dr, Champaign, IL 61822 | 2018-06-20 |
| 1437559028 | The Carle Foundation Hospital | Durable Medical Equipment & Medical Supplies | 611 W Park St, Urbana, IL 61801-2500 | 2014-09-02 |
| 1205236924 | The Carle Foundation Hospital | Durable Medical Equipment & Medical Supplies | 2300 N Vermilion St, Danville, IL 61832-1735 | 2014-08-29 |
| Street Address |
611 W PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193416 | Mark L Saxton | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2005-06-10 |
| 1083214514 | Karissa Nelson | Physical Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-10-26 |
| 1720698756 | Justin Matthew Felix | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-04 |
| 1033729306 | Patricia Fairchild | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-03 |
| 1851909782 | Shruti Agarwal | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-16 |
| 1396363321 | Muhammad Umair Rana | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-07 |
| 1740807817 | Salma Malik | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-06 |
| 1477171536 | Audrey T Lam | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1255959318 | Corbin Reid Mah | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1093332652 | Knika Sethi | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
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| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770096521 | Osf Healthcare System | Rehabilitation Unit | 1400 W Park St, Urbana, IL 61801-2334 | 2017-11-14 |
| 1184676579 | Presence Central and Suburban Hospitals Network | Rehabilitation Unit | 1400 W Park St, Urbana, IL 61801-9901 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245672658 | Via Physical Therapy, P.C. | Rehabilitation Unit | 4513 Lincoln Ave Ste 212, Lisle, IL 60532-1291 | 2013-07-25 |
| 1659605814 | Elmhurst Rehabilitation Services, P.C. | Rehabilitation Unit | 360 W Butterfield Rd Ste 150, Elmhurst, IL 60126-5099 | 2009-09-21 |
| 1003933797 | Silver Cross Hospital & Medical Centers | Rehabilitation Unit | 1900 Silver Cross Blvd., New Lenox, IL 60451-9508 | 2007-03-26 |
| 1902941628 | Alexian Brothers Medical Center | Rehabilitation Unit | 935 Beisner Rd, Elk Grove Village, IL 60007-3475 | 2007-02-20 |
| 1225122047 | Southern Illinois Hospital Services | Rehabilitation Unit | 201 S. 14th, Herrin, IL 62948 | 2006-10-03 |
| 1780686758 | Merit Lincoln Park LLC | Rehabilitation Unit | 550 W Webster Ave, Chicago, IL 60614-3965 | 2005-08-10 |
| 1316413313 | Pipeline - Weiss Memorial Hospital, LLC | Rehabilitation Unit | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2018-10-17 |
| 1699241612 | Pipeline-westlake Hospital, LLC | Rehabilitation Unit | 1225 W Lake St, Melrose Park, IL 60160-4039 | 2018-10-17 |
| 1134607005 | Advocate North Side Health Network | Rehabilitation Unit | 836 W Wellington Ave, Chicago, IL 60657 | 2018-08-02 |
| 1679007215 | Partriot Pilates, Inc | Rehabilitation Unit | 932 S State St, Lockport, IL 60441-3436 | 2017-04-19 |
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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.