PROCTOR HEALTH SYSTEMS (NPI# 1629022447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629022447 |
| Entity Type | Organization |
| Organization Name | PROCTOR HEALTH SYSTEMS |
| Other Organization Name | LAKE OF THE WOODS MEDICAL CENTER |
| Practice Address |
12315 N Knoxville Ave Dunlap IL 61525-9501 |
| Mailing Address |
5401 N Knoxville Ave Suite 209 Peoria IL 61614-5098 |
| Practice Telephone | 3092435575 |
| Practice Fax Number | 3092435764 |
| Mailing Telephone | 3096896049 |
| Mailing Fax Number | 3096896092 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-08-07 |
| Authorized Official Name | CARRIE CHIARAVALLE (DIRECTOR) |
| Authorized Official Telephone | 3096896049 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROCTOR HEALTH SYSTEMS |
| 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 |
|---|---|
| LAKE OF THE WOODS MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396923702 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave Ste 306, Peoria, IL 61614-5021 | 2008-02-07 |
| 1720223837 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Ste 217, Peoria, IL 61614-5098 | 2008-12-04 |
| 1548460108 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 209, Peoria, IL 61614-5098 | 2007-07-23 |
| 1033163761 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 103, Peoria, IL 61614-5098 | 2006-05-19 |
| 1518910363 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 218, Peoria, IL 61614-5098 | 2006-05-19 |
| 1306890108 | Proctor Health Systems | Clinic/Center | 5401 N Knoxville Ave, Suite 300, Peoria, IL 61614-5098 | 2006-05-19 |
| 1134173917 | Proctor Health Systems | Nurse Anesthetist, Certified Registered | 5401 N Knoxville Ave, Suite 209, Peoria, IL 61614-5098 | 2006-05-19 |
| 1740234533 | Proctor Health Systems | Clinic/Center | 210 N 4th St, Chillicothe, IL 61523-2058 | 2006-05-19 |
| 1437103231 | Proctor Health Systems | Clinic/Center | 1506 W Garfield Ave, Bartonville, IL 61607-1755 | 2006-05-19 |
| 1578515953 | Proctor Health Systems | Clinic/Center | 202 S Main St, Lacon, IL 61540-1416 | 2006-05-16 |
| Street Address |
12315 N KNOXVILLE AVE |
| City | DUNLAP |
| State | IL |
| Zip Code | 61525-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821512674 | Kids Thrive Therapy, LLC | Speech-Language Pathologist | 11221 N Blackstone Court, Dunlap, IL 61525 | 2017-08-02 |
| 1679857536 | Manish Patel | Pharmacist | 1700 W. Hickory Grove Rd, Apt 3-209, Dunlap, IL 61525 | 2011-10-10 |
| 1134302839 | Thomas Rickey | Pharmacist | 10424 N Osage Ct, Dunlap, IL 61525 | 2007-12-17 |
| 1427116854 | Maple Shade Dental Group | Dentist | 11825 N Knoxville Ave, Dunlap, IL 61525 | 2006-12-05 |
| 1407213796 | Tommy Bohannan | Durable Medical Equipment & Medical Supplies | 11417 N Boulder Creek Ct, Dunlap, IL 61525-1500 | 2016-01-19 |
| 1225499080 | Bohannan Medical Dist., LLC | Durable Medical Equipment & Medical Supplies | 11417 N Boulder Creek Ct, Dunlap, IL 61525-1500 | 2016-03-08 |
| 1437770872 | Laurie Michelle Kaplan | Dietitian, Registered | 12603 N. Feucht Rd, Dunlap, IL 61525-6152 | 2020-04-27 |
| 1255859575 | Kay Lynn Trilikis | Speech-Language Pathologist | 11230 N Greenview Ln, Dunlap, IL 61525-7542 | 2017-09-07 |
| 1891944864 | Naby Nature's Hand Inc | Massage Therapist | 307 S 4th St, Dunlap, IL 61525-8025 | 2008-09-15 |
| 1891820312 | Mapleshade Vision Center Inc. | Optometrist | 11825 State Route 40, Suite 101, Dunlap, IL 61525-8842 | 2007-02-23 |
| Find all providers in zip 61525 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033724901 | Ar Healthcare | Clinic/Center | 11 E Main St Ste A, St Charles, IL 60174-1925 | 2020-09-08 |
| 1568073674 | Downers Grove Immediate Care Inc. | Clinic/Center | 425 Ogden Ave, Downers Grove, IL 60515-3066 | 2020-08-12 |
| 1538792221 | Greenbax Health Solutions, LLC | Clinic/Center | 4922 W Chicago Ave, Chicago, IL 60651-3142 | 2020-02-20 |
| 1548808728 | Unitypoint Health At Work | Clinic/Center | 1100 13th Ave, East Moline, IL 61244-1455 | 2019-12-18 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.