Petersen Health Care - Illini, Llc in Peoria - Skilled Nursing Facility
Petersen Health Care - Illini, Llc - NPI 1619083730
Petersen Health Care - Illini, Llc is a Skilled Nursing Facility in Peoria, Illinois. Petersen Health Care - Illini, Llc practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Petersen Health Care - Illini, Llc is 1619083730. The last update date is 2017-03-28.
Petersen Health Care - Illini, Llc's current location address is 830 W. Trailcreek Drive, Peoria, Illinois. You can contact this provider via phone number 3096918113 and fax number 3096918622. The mailing address for Petersen Health Care - Illini, Llc is 830 W. Trailcreek Drive, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Petersen Health Care - Illini, Llc |
|---|---|
| Address | 830 W. Trailcreek Drive, Peoria, Illinois |
| Phone Number | 3096918113 |
| Fax Number | 3096918622 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Petersen B. Mark |
| Telephone Number | 3096918113 |
NPI Number Detail
| NPI Number | 1619083730 |
|---|---|
| Provider Enumeration Date | 2006-08-22 |
| Last Updated Date | 2017-03-28 |
Provider Mailing Address Detail
| Address | 830 W. Trailcreek Drive |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 61614 |
| Phone Number | 3096918113 |
| Fax Number | 3096918622 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 42440 |
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Definition: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 300318970007 | IL | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Petersen Health Care - Illini, Llc by the Centers for Medicare & Medicaid Services?
The Petersen Health Care - Illini, Llc has been assigned the NPI (National Provider Identifier) 1619083730. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Petersen Health Care - Illini, Llc?
The Petersen Health Care - Illini, Llc is situated at 830 W. Trailcreek Drive, in the city of Peoria, state of IL, with the zip code 61614.
What is Petersen Health Care - Illini, Llc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Petersen Health Care - Illini, Llc is Skilled Nursing Facility, and the taxonomy code that categorizes this field of expertise is 314000000X.
When was the Petersen Health Care - Illini, Llc's 1619083730 issued?
The Petersen Health Care - Illini, Llc's 1619083730 was issued on 2006-08-22.
As of what date were the details pertaining to Petersen Health Care - Illini, Llc last refreshed?
The information related to the Petersen Health Care - Illini, Llc, including its address, specialty, and other relevant details, was last updated on 2017-03-28.