JULIA RACKLEY PERRY MEMORIAL HOSPITAL (NPI# 1124021308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124021308 |
| Entity Type | Organization |
| Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Other Organization Name | PERRY MEMORIAL HOSPITAL |
| Practice Address |
530 Park Ave E Princeton IL 61356-3901 |
| Practice Telephone | 8158752811 |
| Practice Fax Number | 8158764455 |
| Mailing Telephone | 8158752811 |
| Mailing Fax Number | 8158764455 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR) |
| Authorized Official Telephone | 8158762293 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
0001883 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 336006057001 | 05 | |
| IL | 336006057401 | 05 | |
| IL | JOHN DEERE | A61356001 | 01 |
| IL | BLUE CROSS | 122 | 01 |
| IL | HEALTH ALLIANCE | 001193 | 01 |
| Other Name | Type Code |
|---|---|
| Perry Memorial Hospital | 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 |
| 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 |
| 1578922050 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 535 Park Ave E, Princeton, IL 61356-3901 | 2016-02-12 |
| Street Address |
530 PARK AVE E |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1922411602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E, Princeton, IL 61356-3901 | 2014-06-10 |
| 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 | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780688333 | Caldwell County Hospital, Inc | General Acute Care Hospital | 101 Hospital Dr, Princeton, KY 42445-2301 | 2005-06-10 |
| 1730587809 | Gibson General Hospital Inc | General Acute Care Hospital | 4840 S Maple Tree Dr, Princeton, IN 47670-9277 | 2014-12-05 |
| 1386044279 | Gibson General Hospital | General Acute Care Hospital | 1808 Sherman Dr, Suite 2209, Princeton, IN 47670-1043 | 2014-08-27 |
| 1558346007 | Gibson General Hospital Inc. | General Acute Care Hospital | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2005-12-07 |
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|---|---|---|---|---|
| 1144846353 | Express Care, LLC | General Acute Care Hospital | 11 E Adams St Ste 1100, Chicago, IL 60603-6315 | 2020-06-23 |
| 1508152745 | Medical Connections | General Acute Care Hospital | 25749 Sunnymere Dr, Plainfield, IL 60585-1290 | 2011-06-27 |
| 1205127529 | Hammond Henry Hospital | General Acute Care Hospital | 1604 Cleveland Rd, Colona, IL 61241-8970 | 2011-04-20 |
| 1578885182 | Hillsboro Area Hospital | General Acute Care Hospital | 120 W Saint John St, Ste 2, Litchfield, IL 62056-2169 | 2010-02-23 |
| 1174787394 | Nenita P Cudiamat | General Acute Care Hospital | 668 Warwick Dr, Carol Stream, IL 60188-4332 | 2008-07-16 |
| 1740479047 | Benjamin David Tyrrell | General Acute Care Hospital | 1580 Sherman Ave, Ph04, Evanston, IL 60201-4465 | 2007-10-23 |
| 1881801330 | Natalie L Hughes | General Acute Care Hospital | 14293 Cr 3900 E, San Jose, IL 62682 | 2007-05-16 |
| 1023138864 | Morrison Community Hospital | General Acute Care Hospital | 333 Chicago Ave, Savanna, IL 61074-1964 | 2007-03-29 |
| 1720131667 | A. Koranteng Medical Ltd | General Acute Care Hospital | 419 Ridgemoor Dr, Willowbrook, IL 60527-5418 | 2007-01-22 |
| 1932275641 | Carlinville Area Hospital Association | General Acute Care Hospital | 1001 Morgan St, Carlinville, IL 62626-1448 | 2006-11-27 |
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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.