Tuscola Hco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

TUSCOLA HCO, LLC

Practice address

1203 Egyptian TRL
Tuscola, IL 61953-2050

Phone

(217) 253-4791

NPI assigned

Feb 17, 2020

Last updated

Feb 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark B. Petersen

Title

Manager

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1184257362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-689-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 EGYPTIAN TRL",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619532050",
            "telephone_number": "217-253-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSCOLA HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanti Priya Subbarao, MD
• Bart M Tate, PT
• Douglas Alan Teel, D.M.D.
• Payton Turk
• Tuscola Comm Unit School Dist 301
• Tuscola Hco, LLC
• Tuscola Pain & Wellness Center SC
• Brooke Michaela Vonlanken, PHARMD
• WC- Tuscola Ops, LLC (Brookstone Estates Tuscola)
• Debra Wells, CNA

• Skilled Nursing Facility in Tuscola, IL
• Providers in Tuscola, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.