IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME (NPI# 1790889194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790889194 |
| Entity Type | Organization |
| Organization Name | IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME |
| Other Organization Name | IMH MULTI-SPECIALTY PHYSICIANS |
| Practice Address |
200 Laird Ln Watseka IL 60970-7568 |
| Practice Telephone | 8154325411 |
| Practice Fax Number | 8154323955 |
| Mailing Telephone | 8154325411 |
| Mailing Fax Number | 8154323955 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-09-19 |
| Authorized Official Name | CHUCK BOHLMANN (PRESIDENT/CEO) |
| Authorized Official Telephone | 8154327736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| IMH Multi-Specialty Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992894802 | Iroquois Memorial Hospital and Resident Home | Skilled Nursing Facility | 200 E Fairman Avenue, Watseka, IL 60970-1644 | 2006-10-11 |
| 1467470906 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 303 N 7th St, Kentland, IN 47951-1379 | 2006-07-17 |
| 1578580346 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 34 E Jones St, Milford, IL 60953-1046 | 2006-07-16 |
| 1366469132 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 508 E Crescent St, Gilman, IL 60938-1702 | 2006-07-16 |
| 1366447617 | Iroquois Memorial Hospital and Resident Home | Home Health | 200 Laird Ln, Watseka, IL 60970-7568 | 2005-06-14 |
| 1447610472 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 200 Laird Ln, Watseka, IL 60970-7568 | 2016-03-03 |
| 1285718478 | Iroquois Memorial Hospital and Resident Home | Medicare Defined Swing Bed Unit | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2006-10-24 |
| 1629003470 | Iroquois Memorial Hospital and Resident Home | Pharmacy | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2006-07-11 |
| 1841295763 | Iroquois Memorial Hospital and Resident Home | Hospice Care, Community Based | 200 Laird Ln, Iroquois Regional Health Center, Watseka, IL 60970-7568 | 2005-06-16 |
| Street Address |
200 LAIRD LN |
| City | WATSEKA |
| State | IL |
| Zip Code | 60970-7568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366447617 | Iroquois Memorial Hospital and Resident Home | Home Health | 200 Laird Ln, Watseka, IL 60970-7568 | 2005-06-14 |
| 1447610472 | Iroquois Memorial Hospital and Resident Home | Clinic/Center | 200 Laird Ln, Watseka, IL 60970-7568 | 2016-03-03 |
| 1851721948 | Janella Schroeder | Nurse Practitioner | 200 Laird Ln, Watseka, IL 60970-7568 | 2013-11-26 |
| 1497097679 | Cristiane White | Speech-Language Pathologist | 200 Laird Ln, Watseka, IL 60970-7568 | 2013-03-26 |
| 1851641138 | Kristy M Huse | Occupational Therapist | 200 Laird Ln, Watseka, IL 60970-7568 | 2012-09-14 |
| 1588914782 | William S. Cooke | Physical Therapist | 200 Laird Ln, Watseka, IL 60970-7568 | 2012-09-14 |
| 1134445851 | Iroquois Memorial Hospital | General Practice | 200 Laird Ln, Watseka, IL 60970-7568 | 2010-04-20 |
| 1376876250 | Optech Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 200 Laird Ln, Watseka, IL 60970-7568 | 2009-09-10 |
| 1114076080 | Angelita Fontanilla | Pediatrics | 200 Laird Ln, Watseka, IL 60970-7568 | 2007-01-09 |
| 1104975978 | Abraham Fontanilla | Surgery | 200 Laird Ln, Watseka, IL 60970-7568 | 2007-01-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376189167 | Malinda S Mustered | Occupational Therapist | 825 S Belmont Ave, Watseka, IL 60970 | 2019-11-27 |
| 1558889188 | K-shayla Lafayette | Nurse Practitioner | 200 E. Fairman Ave., Watseka, IL 60970 | 2017-09-04 |
| 1144354879 | Pamela H. Beall | Counselor | 1801 N. State Route 1, Suite 2, Watseka, IL 60970 | 2007-03-15 |
| 1528111879 | Spine Clinics of America Sc | Chiropractor | 425 E. Walnut Street, Watseka, IL 60970 | 2007-01-19 |
| 1699833970 | Shakeel Sher Khan Sandozi | Surgery | 625 S Fifth Street, Watseka, IL 60970 | 2006-12-05 |
| 1790859866 | David Charles Nagele | Dentist | 130 N Littelfuse Ln, Suite 101, Watseka, IL 60970 | 2006-11-20 |
| 1942389259 | John M Rose | Dentist | 316 E Lincoln Ave, Watseka, IL 60970 | 2006-11-06 |
| 1952324279 | Bonita Jean Rajala | Counselor | 617 East Grant St., Watseka, IL 60970 | 2006-07-26 |
| 1396978177 | Allison Shindelar | Social Worker | 323 Wmulberry St, Watseka, IL 60970-0332 | 2009-08-27 |
| 1356441539 | Petersen Health Operations, LLC | Skilled Nursing Facility | 900 N Market St, Watseka, IL 60970-1048 | 2006-09-25 |
| Find all providers in zip 60970 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740538958 | Iroquois Memorial Hospital & Resident Home | Clinic/Center | 625 S 5th St, Suite A, Watseka, IL 60970-1835 | 2012-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
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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.