ILLINOIS VALLEY COMMUNITY HOSPITAL (NPI# 1902800535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902800535 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Practice Address |
925 West St Peru IL 61354-2757 |
| Practice Telephone | 8152233300 |
| Mailing Telephone | 8152233300 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2009-07-06 |
| Authorized Official Name | MRS. CANDACE A FOSTER (MEDICAL STAFF SPECIALISTS) |
| Authorized Official Telephone | 8157803502 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 0358360001 | IL | Suppliers |
| Y | 282N00000X | General Acute Care Hospital | 0003418 | IL | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469483 | Illinois Valley Community Hospital | Registered Nurse | 1403 Sixth Street, Peru, IL 61354 | 2020-02-17 |
| 1659744167 | Illinois Valley Community Hospital | Clinic/Center | 920 West St Ste 117, Peru, IL 61354-2765 | 2015-11-05 |
| 1114299583 | Illinois Valley Community Hospital | Clinic/Center | 815 N Orlando Smith St, Oglesby, IL 61348-9692 | 2012-02-01 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| 1982789582 | Illinois Valley Community Hospital | General Acute Care Hospital | 925 West Street, Illinois Valley Community Hospital, Peru, IL 61354-2799 | 2006-10-25 |
| 1124596283 | Illinois Valley Community Hospital | Clinic/Center | 310 Walnut St, Peru, IL 61354-1946 | 2018-11-07 |
| 1386005395 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2016-03-18 |
| 1306207311 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2016-03-18 |
| 1578929816 | Illinois Valley Community Hospital | Clinic/Center | 1305 6th St, Peru, IL 61354-2759 | 2015-12-31 |
| 1851764369 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 311, Peru, IL 61354-2763 | 2015-11-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ILLINOIS VALLEY COMMUNITY HOSPITAL | 925 West St, Peru, IL 61354-2757 |
| Street Address |
925 WEST ST |
| City | PERU |
| State | IL |
| Zip Code | 61354-2757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437799 | Alison Jeanne Wojack | Nurse Anesthetist, Certified Registered | 925 West St, Peru, IL 61354-2757 | 2020-05-04 |
| 1619435252 | Amy Lynn Smith | Nurse Practitioner | 925 West St, Peru, IL 61354-2757 | 2019-03-02 |
| 1710450275 | Miranda Reinhardt | Dietitian, Registered | 925 West St, Peru, IL 61354-2757 | 2019-01-08 |
| 1932675113 | Michelle Serpico | Nurse Practitioner | 925 West St, Peru, IL 61354-2757 | 2018-10-16 |
| 1548735988 | Angela M. Longeville | Nurse Practitioner | 925 West St, Peru, IL 61354-2757 | 2018-10-12 |
| 1285127563 | Alyssa Christine Salz | Dietitian, Registered | 925 West St, Peru, IL 61354-2757 | 2018-06-11 |
| 1619469608 | Maureen Rebholz | Registered Nurse | 925 West St, Peru, IL 61354-2757 | 2018-06-05 |
| 1568953537 | Deborah Redd | Registered Nurse | 925 West St, Peru, IL 61354-2757 | 2018-05-24 |
| 1629589684 | Jon Gestl | Nurse Anesthetist, Certified Registered | 925 West St, Peru, IL 61354-2757 | 2017-10-17 |
| 1154840221 | Brittany Kaye Lange | Nurse Practitioner | 925 West St, Peru, IL 61354-2757 | 2017-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1205469483 | Illinois Valley Community Hospital | Registered Nurse | 1403 Sixth Street, Peru, IL 61354 | 2020-02-17 |
| 1689228322 | Zhong Xue | Dentist | 5301 Il-251, Ste A, Peru, IL 61354 | 2019-07-31 |
| 1003281668 | Christopher Shane Smith | Physical Therapist | 1400 Midtown Road, Peru, IL 61354 | 2015-12-08 |
| 1770823197 | Muscle Pain Clinic Inc | Chiropractor | 4231 Progress Blvd Ste 4, Peru, IL 61354 | 2013-02-21 |
| 1306194451 | Vijaya Lakshmi Bathina | Dentist | 5301 Route 251, Peru, IL 61354 | 2012-08-21 |
| 1225305634 | Walgreens | Point of Service | 1033 Shooting Park Road, Peru, IL 61354 | 2011-11-30 |
| 1811293574 | Charles Riva | Physical Therapist | 4461 N. Progress Blvd., Peru, IL 61354 | 2011-01-28 |
| 1932403896 | Emerging Vision, Inc | Eyewear Supplier (Equipment, not the service) | 3940 Route 251, Peru Mall Suite F-1, Peru, IL 61354 | 2011-01-06 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| Find all providers in zip 61354 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982789582 | Illinois Valley Community Hospital | General Acute Care Hospital | 925 West Street, Illinois Valley Community Hospital, Peru, IL 61354-2799 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442266 | Pipeline-west Suburban Medical Center, LLC | General Acute Care Hospital | West Suburban Medical Center, 3 Erie Court, Oak Park, IL 60302-2519 | 2018-10-10 |
| 1093241275 | Northwest Community Hospital | General Acute Care Hospital | 2704 Royal Saint Georges Ct, Saint Charles, IL 60174-8754 | 2017-05-05 |
| 1831620632 | Macneal Hospital | General Acute Care Hospital | 665 Grove Dr Apt 112, Buffalo Grove, IL 60089-4038 | 2017-03-23 |
| 1801337506 | University of Chicago Medical Center | General Acute Care Hospital | 1122 Paysphere Cir, Chicago, IL 60674-0011 | 2017-03-14 |
| 1861935181 | Sarah Landon | General Acute Care Hospital | 6407 Martin St, Crystal Lake, IL 60014-4959 | 2016-11-19 |
| 1942750831 | Advocate Good Samaritan | General Acute Care Hospital | 4427 Woodward Ave, Downers Grove, IL 60515 | 2016-10-04 |
| 1063960870 | Mid America Emergency Medicine | General Acute Care Hospital | 700 N First St, Springfield, IL 62781-0001 | 2016-09-21 |
| 1336598937 | Daniel Benjamin Holt Jr. | General Acute Care Hospital | 2448 N Seminary Ave, Apt 2b, Chicago, IL 60614-7445 | 2016-06-06 |
| 1841650942 | Latoyia Roman | General Acute Care Hospital | 6756 S Oglesby Ave, Unit 1, Chicago, IL 60649-1316 | 2016-03-02 |
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
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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.