East Peoria Gardens Healthcare

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0045492 Issued in IL

Legal business name

EAST PEORIA GARDENS HEALTHCARE

Practice address

1910 Springfield Rd
East Peoria, IL 61611-4343

Phone

(847) 329-1555

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Debbie Spector-Mammoser

Title

Medicare Supervisor

Phone

(847) 329-1555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1699810093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772545",
            "telephone_number": "847-329-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SPRINGFIELD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114343",
            "telephone_number": "847-329-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PEORIA GARDENS HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "SPECTOR-MAMMOSER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "MEDICARE SUPERVISOR",
        "authorized_official_telephone_number": "847-329-1555"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0045492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarence E Dukes, MD
• Christina D Durbin, DC
• East Peoria Comm High SCH 309
• East Peoria Counseling LLC
• East Peoria Elementary Dist 86
• East Peoria NH LLC (River Crossing of East Peoria)
• East Peoria Walk-in Chiropractic LLC
• Nancy S. Egger, L.C.S.W.
• Hilary Enzweiler
• Adebimpe Favour Erebholo, NP

• Skilled Nursing Facility in East Peoria, IL
• Providers in East Peoria, 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 22, 2008; 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.