Phillips Investments, LLC - East Peoria Operation Series

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PHILLIPS INVESTMENTS, LLC - EAST PEORIA OPERATION SERIES

Practice address

1000 Centennial Dr
East Peoria, IL 61611-4916

Phone

(309) 324-0880

NPI assigned

Oct 5, 2024

Organization subpart

Yes

Parent organization

PHILLIPS INVESTMENTS, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Randy Porter, CFO

Title

Chief Financial Officer

Phone

(217) 345-5022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1255150413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619204343",
            "telephone_number": "217-345-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTENNIAL DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114916",
            "telephone_number": "309-324-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS INVESTMENTS, LLC - EAST PEORIA OPERATION SERIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHILLIPS INVESTMENTS, LLC",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "217-345-5022",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petersen Health Operations, LLC
• Steven Petri
• Taylor Pham
• Tony Pham
• Jonathan Phen
• Taylor Phillips, PHARMD
• Kaylee Elizabeth Polen, FNP-C
• Nathan E. Porch, O.T.
• Progressive Housing
• Progressive Housing, Inc.

• Assisted Living Facility in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.