Active NPI
Ranchero Clinic, LLC
- Clinic/Center
- Charleston, IL
National Provider Identifier
1457245029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- RANCHERO CLINIC, LLC
- Practice address
- 825 18TH St Ste 238
Charleston, IL 61920-2940 - Phone
- (630) 696-0714
- NPI assigned
- Jun 6, 2025
- Last updated
- Jun 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bernie C Ranchero, MD
- Title
- President
- Phone
- (630) 696-0714
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
825 18TH St Ste 238
Charleston, IL 61920-2940
Mailing address
1034 W Polk Ave
Charleston, IL 61920-1709
Phone (630) 696-0714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568656445 | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Ranchero Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Charleston, IL
- NPI 1568656445
-
- Family Nurse Practitioner
- Champaign, IL
- NPI 1770123804
-
- Nurse Practitioner
- Effingham, IL
- NPI 1487529368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749168000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1749168000000",
"number": "1457245029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 W POLK AVE",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619201709",
"telephone_number": "630-696-0714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 18TH ST STE 238",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619202940",
"telephone_number": "630-696-0714"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANCHERO CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-06",
"last_updated": "2025-06-06",
"certification_date": "2025-06-06",
"status": "A",
"authorized_official_last_name": "RANCHERO",
"authorized_official_first_name": "BERNIE",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-696-0714",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1568656445",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.