NPIMap

Organization Active NPI

Community Medical Center of Western Illinois Inc

  • Pediatric Skilled Nursing Facility
  • Monmouth, IL
National Provider Identifier
1447239728
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
Legal business name
COMMUNITY MEDICAL CENTER OF WESTERN ILLINOIS INC
Practice address
1000 W Harlem Avenue
Monmouth, IL 61462-1099
Phone
(309) 734-3141
Fax
(309) 734-3029
NPI assigned
Jan 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Brett L Stahl
Title
Projects Coordinator
Phone
(309) 734-1431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X Primary

Addresses

Primary practice location

1000 W Harlem Avenue
Monmouth, IL 61462-1099

Mailing address

1000 W Harlem Avenue
Monmouth, IL 61462-1099
Phone (309) 734-3141

Other identifiers 1

IdentifierTypeStateIssuer
14 5528OtherILMEDICARE PART A

Other names 1

  • Bed Wing Other name

National Provider Directory

National Provider Directory
Tax ID family
Osf Healthcare System50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447239728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVENUE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621099",
            "telephone_number": "309-734-3141",
            "fax_number": "309-734-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVENUE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621099",
            "telephone_number": "309-734-3141",
            "fax_number": "309-734-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL CENTER OF WESTERN ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STAHL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROJECTS COORDINATOR",
        "authorized_official_telephone_number": "309-734-1431",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A",
            "identifier": "14 5528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bed Wing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monmouth, IL

Sources for this page

  • 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.