NPIMap

Organization Active NPI

Cunningham Children's Home of Urbana Il

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Urbana, IL
National Provider Identifier
1487148938
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CUNNINGHAM CHILDREN'S HOME OF URBANA IL
Practice address
208 E Washington St
Urbana, IL 61801-4227
Phone
(217) 367-3728
Fax
(217) 367-3728
NPI assigned
Jun 19, 2018
Last updated
Jun 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Shawn Suzette Peterson
Title
Director of Quality Improvement
Phone
(217) 367-3728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

208 E Washington St
Urbana, IL 61801-4227

Mailing address

1301 N Cunningham Ave
Urbana, IL 61802-1830
Phone (217) 367-3728

Other identifiers 1

IdentifierTypeStateIssuer
37062521007MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Cunningham Children's Home of Urbana Il10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1301 N Cunningham Ave
Urbana, IL 61802
Phone (217) 337-9040

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1487148938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N CUNNINGHAM AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618021830",
            "telephone_number": "217-367-3728",
            "fax_number": "217-367-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E WASHINGTON ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618014227",
            "telephone_number": "217-367-3728",
            "fax_number": "217-367-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUNNINGHAM CHILDREN'S HOME OF URBANA IL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "SUZETTE",
        "authorized_official_title_or_position": "DIRECTOR OF QUALITY IMPROVEMENT",
        "authorized_official_telephone_number": "217-367-3728"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37062521007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.