Petersen Health Network, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PETERSEN HEALTH NETWORK, LLC

Doing business as

Rochelle Gardens Care Center

Practice address

1021 N Caron Rd
Rochelle, IL 61068-9647

Phone

(815) 562-4047

Fax

(815) 562-8017

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Mark Petersen

Title

President

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

Other names 1

• Rochelle Gardens Care Center Doing business as

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1649396524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N CARON RD",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610689647",
            "telephone_number": "815-562-4047",
            "fax_number": "815-562-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochelle Gardens Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacey J Patla
• Amanda Perez-Garcia, MD
• Lisa K Perino, PSY D
• Sharda Bramhawatie Persaud, PHARMD
• Petersen Companies, LLC (Rochelle Rehabiliation & Health Care Center)
• Petersen Health Network, LLC (Rochelle Rehabilitation & Health Care Center)
• Physician Care at Home Management Company LLC
• Chad Monroe Piller, DC
• Jason C Popp, MD
• Sushmita Nallamothu Prathipati, M.D.

• Skilled Nursing Facility in Rochelle, IL
• Providers in Rochelle, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.