ILLINOIS VALLEY COMMUNITY HOSPITAL (NPI# 1831521947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831521947 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Other Organization Name | IVCH MEDICAL GROUP / ENT & ALLERGY CENTER |
| Practice Address |
920 West St Sutie 312 Peru IL 61354-2763 |
| Mailing Address |
1305 6th St Peru IL 61354-2759 |
| Practice Telephone | 8152234400 |
| Practice Fax Number | 8152234401 |
| Mailing Telephone | 8157805030 |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-07-31 |
| Authorized Official Name | DORI BONNELL (DIRECTOR OF PHYSICIAN PRACTICES) |
| Authorized Official Telephone | 8157803222 |
| Is Organization Subpart | Y |
| Parent Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| IVCH Medical Group / ENT & Allergy Center | Doing Business As Name - Organization |
| 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 |
920 WEST ST SUTIE 312 |
| City | PERU |
| State | IL |
| Zip Code | 61354-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114939 | Mark Allen Fernandez | Internal Medicine | 920 West St, Ste 311, Peru, IL 61354-2770 | 2005-06-16 |
| 1386199511 | Jennifer Leeann Olesen | Nurse Practitioner | 920 West St, Suite #311, Peru, IL 61354-2763 | 2016-08-17 |
| 1851764369 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 311, Peru, IL 61354-2763 | 2015-11-05 |
| 1598138000 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Bldg B, Peru, IL 61354-2763 | 2015-11-05 |
| 1467884650 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 312, Peru, IL 61354-2763 | 2013-07-30 |
| 1073871893 | Ram L & Neelam Goel Ptr | Internal Medicine | 920 West St, Suite 116, Peru, IL 61354-2763 | 2012-04-30 |
| 1912295270 | Illinois Valley Community Hospital | Family Medicine | 920 West St, Suite 311, Peru, IL 61354-2763 | 2011-07-20 |
| 1710281787 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 216, Peru, IL 61354-2763 | 2011-01-05 |
| 1699005678 | Angela Marie Vezzetti | Physician Assistant | 920 West St, Suite 312, Peru, IL 61354-2763 | 2010-01-13 |
| 1467615898 | Shyrlena L Bogard | Obstetrics & Gynecology | 920 West St, Bldg B, Peru, IL 61354-2763 | 2008-07-07 |
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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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891976296 | Travel Center Clinics | Clinic/Center | 3130 May Rd, Peru, IL 61354-9618 | 2007-11-14 |
| 1356904163 | St Margaret's Hospital | Clinic/Center | 1650 Midtown Rd, Peru, IL 61354-1200 | 2019-04-17 |
| 1518439710 | Mac Chiropractic LLC | Clinic/Center | 3815 Progress Blvd Ste C, Peru, IL 61354-1188 | 2018-12-28 |
| 1467884650 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 312, Peru, IL 61354-2763 | 2013-07-30 |
| 1417117540 | Donahue Chiropractic Center | Clinic/Center | 1915 4th St, Suite 2, Peru, IL 61354-3361 | 2008-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
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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.