Pekin Memorial Hospital

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1002419 Issued in IL

Legal business name

PEKIN MEMORIAL HOSPITAL

Practice address

2934 Court St
Pekin, IL 61554-6229

Phone

(309) 353-0406

Fax

(309) 347-1240

NPI assigned

Jul 21, 2006

Organization subpart

Yes

Parent organization

PEKIN MEMORIAL HOSPITALAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Jepson

Title

Ceo

Phone

(309) 353-0756

Specialties & licenses 1

Addresses

Other names 1

• Pekin Hospital HHC Doing business as

Part of

Pekin Mem Hosp Cardiolo

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Igor Sister, M.D.

  • Hospitalist Physician
  • San Diego, CA
  • NPI 1518149467
  NPD (past)
• Choua Thao, M.D.

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1053653576
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1033130752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S 13TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544936",
            "telephone_number": "309-353-0406",
            "fax_number": "309-347-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546229",
            "telephone_number": "309-353-0406",
            "fax_number": "309-347-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEKIN MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEKIN MEMORIAL HOSPITAL",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "JEPSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-353-0756"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1002419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pekin Hospital HHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pekin Comm School Dist 303
• Pekin Dialysis LLC
• Pekin Family Practice, PC
• Pekin Hospital
• Pekin Hospital
• Pekin Memorial Hospital
• Pekin Memorial Hospital
• Pekin Memorial Hospital
• Pekin Memorial Hospital
• Pekin Memorial Hospital

• Home Health Agency in Pekin, IL
• Providers in Pekin, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.