Petersen Health Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0047571 Issued in IL

Legal business name

PETERSEN HEALTH OPERATIONS, LLC

Doing business as

Sugar Creek Care Center

Practice address

900 N Market St
Watseka, IL 60970-1048

Phone

(815) 432-5261

Fax

(815) 432-5268

NPI assigned

Sep 25, 2006

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

President

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

Other names 1

• Sugar Creek Care Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Petersen Health Operations, LLC

  dba Eastside Rehabilitation & Health Care Center

  • Skilled Nursing Facility
  • Pittsfield, IL
  • NPI 1285672766

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356441539",
    "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": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N MARKET ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701048",
            "telephone_number": "815-432-5261",
            "fax_number": "815-432-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0047571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sugar Creek Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Gale Parsons
• Brant Partain
• Lisa Pearson
• Austin L Pendry
• Petersen Health Care II, Inc (Watseka Rehabilitaion & Health Care Center)
• Jeffrey W. Petersen, ATC
• Casimir Edward Petkunas III, MSW, LSW
• Philip Zumwalt,M.D. (Watseka Family Practice)
• Denise Pillot
• Issac G. Plamoottil, M.D.

• Skilled Nursing Facility in Watseka, IL
• Providers in Watseka, 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 Aug 22, 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.