NPIMap

Organization Active NPI

Starved Rock Regional Center for Therapy & Child Development

  • Voluntary or Charitable Agency
  • Ottawa, IL
National Provider Identifier
1063544401
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
STARVED ROCK REGIONAL CENTER FOR THERAPY & CHILD DEVELOPMENT
Practice address
1013 Adams Street
Ottawa, IL 61354-4304
Phone
(815) 434-0857
Fax
(815) 434-2260
NPI assigned
Mar 12, 2007
Last updated
Jun 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Mrs. Paula Sue WilliamsonNPI 1295856946
Title
Program Director
Phone
(815) 434-0857

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P0010X IL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X IL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X IL
Voluntary or Charitable Agency 251V00000X
Voluntary or Charitable Agency 251V00000X IL Primary

Addresses

Primary practice location

1013 Adams Street
Ottawa, IL 61354-4304

Mailing address

1013 Adams Street
Ottawa, IL 61354-4304
Phone (815) 434-0857

Other identifiers 1

IdentifierTypeStateIssuer
5015093OtherILBCBS

Other names 1

  • Easter Seals of LaSalle & Bureau Counties Former legal business name

National Provider Directory

National Provider Directory

Locations

1013 Adams St
Ottawa, IL 61350
Phone (815) 434-0857

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1063544401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 ADAMS STREET",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613544304",
            "telephone_number": "815-434-0857",
            "fax_number": "815-434-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 ADAMS STREET",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613544304",
            "telephone_number": "815-434-0857",
            "fax_number": "815-434-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARVED ROCK REGIONAL CENTER FOR THERAPY & CHILD DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "815-434-0857",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5015093",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easter Seals of LaSalle & Bureau Counties",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.