JULIA RACKLEY PERRY MEMORIAL HOSPITAL (NPI# 1922411602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922411602 |
| Entity Type | Organization |
| Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Other Organization Name | PERRY MEMORIAL FAMILY HEALTH CLINIC |
| Practice Address |
530 Park Ave E Princeton IL 61356-3901 |
| Practice Telephone | 8158764419 |
| Practice Fax Number | 8158764455 |
| Mailing Telephone | 8158764419 |
| Mailing Fax Number | 8158764455 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-06-15 |
| Authorized Official Name | JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR) |
| Authorized Official Telephone | 8158762293 |
| Is Organization Subpart | Y |
| Parent Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Perry Memorial Family Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
| 1578083051 | Julia Rackley Perry Memorial Hospital | Surgery | 530 Park Ave E Ste 205, Princeton, IL 61356-3902 | 2017-06-26 |
| 1629598602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2017-06-21 |
| 1033649967 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2017-06-13 |
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1134695422 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2018-10-15 |
| 1043786338 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2018-10-15 |
| 1952877243 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Ste 303, Princeton, IL 61356-3903 | 2018-10-15 |
| 1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
| 1326408204 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-03-04 |
| Street Address |
530 PARK AVE E |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1427529577 | Ashley Kannenberg | Dietitian, Registered | 530 Park Ave E, Princeton, IL 61356-2598 | 2018-12-16 |
| 1689126799 | Jo A Muller | Nurse Practitioner | 530 Park Ave E, Ste 207, Princeton, IL 61356-3901 | 2016-10-25 |
| 1578940524 | Jennifer Hoffman | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2015-04-29 |
| 1114326956 | Ketan R Patel | Internal Medicine | 530 Park Ave E, Suite 101, Princeton, IL 61356-3901 | 2014-08-18 |
| 1942551312 | Jenny Gaworski | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-09-26 |
| 1619231719 | Victoria Jeannine Anderson | Physical Therapy Assistant | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-07-03 |
| 1710241286 | Jacquelyn Johnson | Occupational Therapist | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-06-29 |
| 1023372869 | Debra K Austin | Physical Therapist | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-06-26 |
| 1609138858 | Jennifer Lee Heckroth | Physical Therapist | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1639549496 | Elite Medical Associates Pa | Clinic/Center | 10 Forrestal Rd S, Suite 101, Princeton, NJ 08540-6666 | 2015-10-05 |
| 1427426683 | Horizon Family Medicine | Clinic/Center | 213 Barden St, Princeton, NC 27569-7206 | 2015-09-04 |
| 1447481908 | Gregg E Davis Md Ltd | Clinic/Center | 204 Park Ave E, Princeton, IL 61356-2114 | 2009-07-31 |
| 1821242017 | Fairview Clinics | Clinic/Center | 919 Northland Dr, Princeton, MN 55371-2172 | 2008-11-14 |
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| 1033724901 | Ar Healthcare | Clinic/Center | 11 E Main St Ste A, St Charles, IL 60174-1925 | 2020-09-08 |
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| 1265076749 | Inhome Primecare LLC | Clinic/Center | 6738 N Lockwood Ave, Lincolnwood, IL 60712-3107 | 2019-10-29 |
| 1033760780 | Careatc | Clinic/Center | 600 S Michigan Ave # 402, Chicago, IL 60605-1900 | 2019-09-24 |
| 1356814503 | Thompson Medical Incorporated | Clinic/Center | 933 E Hyde Park Blvd Ste G, Chicago, IL 60615-2722 | 2019-01-09 |
| 1598248106 | Granite City Clinic Corp | Clinic/Center | 602 Farrish St, Madison, IL 62060-1567 | 2018-09-10 |
| 1497251037 | Thomas L Pitts, Md LLC | Clinic/Center | 233 E Erie St Ste 702, Chicago, IL 60611-5933 | 2018-04-03 |
| 1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
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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.