ILLINOIS VALLEY COMMUNITY HOSPITAL (NPI# 1164403622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164403622 |
| 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 | 2005-11-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEPHEN DAVIS (CFO) |
| Authorized Official Telephone | 8157803674 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | IL | Hospital Units |
| 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 |
| 1902800535 | Illinois Valley Community Hospital | Durable Medical Equipment & Medical Supplies | 925 West St, Peru, IL 61354-2757 | 2005-06-10 |
| 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 |
| 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 |
|---|---|---|---|---|
| 1902800535 | Illinois Valley Community Hospital | Durable Medical Equipment & Medical Supplies | 925 West St, Peru, IL 61354-2757 | 2005-06-10 |
| 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 |
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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 | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992749691 | Dukes Health System LLC | Medicare Defined Swing Bed Unit | 275 W 12th St, Peru, IN 46970-1638 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316169949 | Alexian Brothers Medical Center | Medicare Defined Swing Bed Unit | 800 Biesterfield Rd Ste 605, Eberle Medical Office Building, Elk Grove Village, IL 60007-3362 | 2007-05-03 |
| 1902854623 | Cgh Medical Center | Medicare Defined Swing Bed Unit | 100 E Le Fevre Rd, Sterling, IL 61081-1278 | 2006-05-05 |
| 1336638915 | Valley West Community Hospital | Medicare Defined Swing Bed Unit | 1302 N Main St, Sandwich, IL 60548-2587 | 2018-05-09 |
| 1447747316 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Medicare Defined Swing Bed Unit | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-04-17 |
| 1912404765 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2018-04-09 |
| 1801212055 | Osf Healthcare System | Medicare Defined Swing Bed Unit | 1051 W South St, Kewanee, IL 61443-8354 | 2014-03-12 |
| 1639595036 | Southern Illinois Hospital Services | Medicare Defined Swing Bed Unit | 2 S Hospital Dr, Murphysboro, IL 62966-3333 | 2014-03-10 |
| 1295066983 | Advocate Health and Hospitals Corp. | Medicare Defined Swing Bed Unit | 101 S Major St, Eureka, IL 61530-1246 | 2010-01-20 |
| 1114199122 | Accuracy Urgent Care | Medicare Defined Swing Bed Unit | 805 W Deyoung St, Suite E, Marion, IL 62959-1604 | 2008-03-31 |
| 1174713440 | St Francis Hospital Sisters of The Third Order of St Francis | Medicare Defined Swing Bed Unit | 1215 Franciscan Dr, Box 1215, Litchfield, IL 62056-1778 | 2007-08-01 |
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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.