NPIMap

Organization Active NPI

St. Margaret's Health-Peru

Doing business as Ivch Medical Group / Peru Medical Clinic

  • Medical Specialty Clinic/Center
  • Peru, IL
National Provider Identifier
1245429380
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ST. MARGARET'S HEALTH-PERU
Doing business as
Ivch Medical Group / Peru Medical Clinic
SMH-Peru/Peru Medical Clinic
Practice address
920 West St Ste 117
Peru, IL 61354-2765
Phone
(815) 223-3500
Fax
(815) 223-1790
NPI assigned
Oct 15, 2007
Last updated
Jan 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. MARGARET'S HEALTH-PERUAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Dori C Bonnell
Title
Director of Physician Practices
Phone
(815) 780-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

920 West St Ste 117
Peru, IL 61354-2765

Mailing address

1305 6TH St
Peru, IL 61354-2759
Phone (815) 223-3500

Other identifiers 1

IdentifierTypeStateIssuer
05000342OtherBC/BS

Other names 2

  • IVCH MEDICAL GROUP / PERU MEDICAL CLINIC Doing business as
  • SMH-Peru/Peru Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
St Margarets Health-Peru

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1245429380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 6TH ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542759",
            "telephone_number": "815-223-3500",
            "fax_number": "815-223-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST ST STE 117",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542765",
            "telephone_number": "815-223-3500",
            "fax_number": "815-223-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARGARET'S HEALTH-PERU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARGARET'S HEALTH-PERU",
        "enumeration_date": "2007-10-15",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "BONNELL",
        "authorized_official_first_name": "DORI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "815-780-3222"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "05000342",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVCH MEDICAL GROUP / PERU MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IVCH MEDICAL GROUP / PERU MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMH-Peru/Peru Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.