Petersen Health Care II, Inc.
Organization Active NPI Skilled Nursing Facility · Sullivan, IL
NPI 1376794511 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1376794511
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0046425 (IL)
- Legal business name
- PETERSEN HEALTH CARE II, INC.
- Practice address
- 11 Hawthorne LN
Sullivan, IL 61951-9490 - Phone
- (217) 728-4327
- NPI assigned
- Oct 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Mark B. Petersen
- Title
- Manager
- Phone
- (309) 689-5880
Corporate family (same tax ID) 8
National Provider Directory
- Tax ID family
- Petersen Health Care LL Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0046425 | IL | Yes |
Addresses
Primary practice location
11 Hawthorne LN
Sullivan, IL 61951-9490
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113
Other names
- Sullivan Rehabilitation & Health Care Center
Other providers in Sullivan, IL
- Ashley Neikirk
- Jeremy Nolen
- Anne Margaret Osthoff
- Patient First Chiropractic
- Patterson House, Inc
- Petersen Health Care II, Inc.
- Petersen Health Care VII LLC
- Petersen Health Care, Inc
- Victoria Phelps
- Alexandria Elizabeth Poe
All providers in Sullivan, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.