NPIMap

Organization Active NPI

Heartland Community Health Clinic

Doing business as Heartland Health Services - Jefferson

  • Federally Qualified Health Center (FQHC)
  • Peoria, IL
National Provider Identifier
1396799888
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEARTLAND COMMUNITY HEALTH CLINIC
Doing business as
Heartland Health Services - Jefferson
Practice address
228 NE Jefferson Avenue
Peoria, IL 61603-3802
Phone
(309) 671-8000
NPI assigned
May 20, 2006
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Katie Saucedo
Title
Revenue Cycle Manager
Phone
(309) 680-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

228 NE Jefferson Avenue
Peoria, IL 61603-3802

Mailing address

2214 N University St
Peoria, IL 61604-3221
Phone (309) 680-7600

Other names 1

  • Heartland Health Services - Jefferson Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396799888. Details of each certification follow.

  • CCN 141975 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 141975

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HEARTLAND COMMUNITY HEALTH CLINIC (HUMAN SER CTR)
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 10, 2004
Last certification
Feb 10, 2004
Ownership / control type
For profit – corporation
Facility address
228 NE Jefferson Avenue
Peoria, IL 61603

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1396799888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-680-7600",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 NE JEFFERSON AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033802",
            "telephone_number": "309-671-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND COMMUNITY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "SAUCEDO",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "309-680-7600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Health Services - Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.