ILLINOIS VALLEY COMMUNITY HOSPITAL (NPI# 1851764369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851764369 |
| Entity Type | Organization |
| Organization Name | ILLINOIS VALLEY COMMUNITY HOSPITAL |
| Other Organization Name | IVCH MEDICAL GROUP / PERU PRIMARY CARE CLINIC |
| Practice Address |
920 West St Suite 311 Peru IL 61354-2763 |
| Mailing Address |
1305 6th St Peru IL 61354-2759 |
| Practice Telephone | 8152239214 |
| Practice Fax Number | 8152239322 |
| Mailing Telephone | 8157804644 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | DORINDA C 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| IVCH MEDICAL GROUP / PERU PRIMARY CARE CLINIC | 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 SUITE 311 |
| 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 |
| 1598138000 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Bldg B, Peru, IL 61354-2763 | 2015-11-05 |
| 1831521947 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Sutie 312, Peru, IL 61354-2763 | 2013-07-31 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659744167 | Illinois Valley Community Hospital | Clinic/Center | 920 West St Ste 117, Peru, IL 61354-2765 | 2015-11-05 |
| 1598138000 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Bldg B, Peru, IL 61354-2763 | 2015-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
| 1578040275 | Osf Healthcare System | Clinic/Center | 230 S Exchange St, Galva, IL 61434-1871 | 2018-07-25 |
| 1700380219 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1510 W Springfield Rd Ste A, Taylorville, IL 62568-2764 | 2018-03-20 |
| 1326542903 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1001 Avenue of Mid America Ste 4, Effingham, IL 62401-4634 | 2018-03-20 |
| 1649795659 | Harrisburg Medical Center Inc | Clinic/Center | 3106 Outer Dr Ste 200, Marion, IL 62959-5270 | 2017-08-10 |
| 1588186308 | Wabash General Hospital District | Clinic/Center | 1430 College Dr Ste A, Mount Carmel, IL 62863-2649 | 2017-07-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ILLINOIS VALLEY COMMUNITY HOSPITAL.
| 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.