NPIMap

Organization Active NPI

Ranchero Clinic, LLC

Doing business as Ranchero Clinic

  • Rural Health Clinic/Center
  • Charleston, IL
National Provider Identifier
1093606519
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
RANCHERO CLINIC, LLC
Doing business as
Ranchero Clinic
Practice address
825 18TH St Ste 238
Charleston, IL 61920-2940
Phone
(447) 219-1594
Fax
(408) 715-5734
NPI assigned
Jul 12, 2025
Last updated
Jul 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2025

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

Authorized official

Name
Dr. Bernie C Ranchero, MDNPI 1568656445
Title
Owner-President
Phone
(447) 219-1163

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

825 18TH St Ste 238
Charleston, IL 61920-2940

Mailing address

825 18TH St Ste 238
Charleston, IL 61920-2940
Phone (447) 219-1163

Other names 1

  • Ranchero Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ranchero Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

825 18th St
Ste 238
Charleston, IL 61920
Phone (217) 500-5484

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1752278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752278400000",
    "number": "1093606519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 18TH ST STE 238",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202940",
            "telephone_number": "447-219-1163",
            "fax_number": "408-715-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 18TH ST STE 238",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202940",
            "telephone_number": "447-219-1594",
            "fax_number": "408-715-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHERO CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-12",
        "last_updated": "2025-07-12",
        "certification_date": "2025-07-12",
        "status": "A",
        "authorized_official_last_name": "RANCHERO",
        "authorized_official_first_name": "BERNIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "447-219-1163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ranchero Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2025; 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.