NPIMap

Organization Active NPI

Easter Seals-Ucp

  • Case Management Agency
  • West Peoria, IL
National Provider Identifier
1376979195
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EASTER SEALS-UCP
Practice address
3000 W Rohmann Ave
West Peoria, IL 61604-4842
Phone
(309) 672-6360
Fax
(309) 681-0190
NPI assigned
Sep 25, 2013
Organization subpart
Yes
Parent organization
EASTER SEALS-UCPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Mr. James L Runyon
Title
Ex VP
Phone
(309) 686-1177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

3000 W Rohmann Ave
West Peoria, IL 61604-4842

Mailing address

3000 W Rohmann Ave
West Peoria, IL 61604-4842
Phone (309) 672-6360

Other names 1

  • CFC #14 Other name

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals - Ucp4 organizations share this tax ID, including this one
Part of
Easter Seals - Ucp

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1014 W Pioneer Pkwy
Ste 110
Peoria, IL 61615

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1376979195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 W ROHMANN AVE",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616044842",
            "telephone_number": "309-672-6360",
            "fax_number": "309-681-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W ROHMANN AVE",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616044842",
            "telephone_number": "309-672-6360",
            "fax_number": "309-681-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS-UCP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTER SEALS-UCP",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "RUNYON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EX VP",
        "authorized_official_telephone_number": "309-686-1177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CFC #14",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.