PROCTOR COMMUNITY HOSPITAL (NPI# 1033116876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033116876 |
| Entity Type | Organization |
| Organization Name | PROCTOR COMMUNITY HOSPITAL |
| Other Organization Name | PROCTOR HOSPITAL |
| Practice Address |
5409 N Knoxville Ave Peoria IL 61614-5016 |
| Practice Telephone | 3096911000 |
| Practice Fax Number | 3096718265 |
| Mailing Telephone | 3096724813 |
| Mailing Fax Number | 3096718265 |
| Enumeration Date | 2005-07-07 |
| 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 | 282N00000X | General Acute Care Hospital | 1677264 | IL | Hospitals |
| Y | 282N00000X | General Acute Care Hospital | 0001925 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 0117 | 01 |
| 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 |
| 1134475940 | Proctor Community Hospital | Psychiatric Unit | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2012-07-30 |
| 1457679581 | Proctor Community Hospital | Rehabilitation, Substance Use Disorder Unit | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2010-05-13 |
| 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 | 61614-5016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1063806412 | Nicole Lovin | Nurse Practitioner | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2015-03-24 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 61614 | ||||
| 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 |
|---|---|---|---|---|
| 1215376702 | Gajalakshmi Vaka, Md PC | General Acute Care Hospital | 7183 W Camino De Oro, Peoria, AZ 85383-3264 | 2013-06-18 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1184885485 | Osf St. Francis Medical Center | General Acute Care Hospital | 2401 W Alta Rd, Apt. 907, Peoria, IL 61615-1279 | 2008-06-19 |
| 1801340781 | Vhs of Arrowhead, Inc. | General Acute Care Hospital | 26900 N Lake Pleasant Pkwy, Peoria, AZ 85383-1394 | 2016-08-09 |
| 1366858763 | Sue A Behrens | General Acute Care Hospital | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-07-07 |
| 1265787923 | Osf Saint Francis | General Acute Care Hospital | Osf Saint Francis Medical Ctr, 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-07-18 |
| 1144595992 | Osf Saint Francis Medical Center | General Acute Care Hospital | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-03-13 |
| 1790986735 | Edward Alan Hirsch | General Acute Care Hospital | 530 Ne Glen Oak Ave, Peoria, IL 61637-2082 | 2007-05-29 |
| 1477671592 | Osf Healthcare System | General Acute Care Hospital | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2007-03-27 |
| 1164463493 | Saint Francis Medical Center | General Acute Care Hospital | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-06-09 |
| Find all providers in PEORIA | ||||
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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.