Pekin Prohealth Inc

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

009180787 Issued in IL

Legal business name

PEKIN PROHEALTH INC

Doing business as

PHI X-Ray

Practice address

19 Olt Ave
Pekin, IL 61554-6216

Phone

(309) 353-0902

Fax

(309) 347-2623

NPI assigned

Oct 24, 2008

Organization subpart

No

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

Authorized official

Name

Sharon Adams

Title

Vice President

Phone

(309) 353-0787

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PHI X-Ray Doing business as

Tax ID family

Pekin Prohealth Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pekin Prohealth Inc

  dba Procare Home Health Service

  • Oxygen Equipment & Supplies (DME)
  • Peru, IL
  • NPI 1801840822
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chandrasekhar Sompalli, MD

  • Orthopaedic Surgery Physician
  • Berwyn, IL
  • NPI 1669588489
  NPD (past)

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1740433531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S 13TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544936",
            "telephone_number": "309-353-0902",
            "fax_number": "309-347-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLT AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546216",
            "telephone_number": "309-353-0902",
            "fax_number": "309-347-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEKIN PROHEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "309-353-0787"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IL",
            "license": "009180787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009180787",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09015685",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHI X-Ray",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pekin Memorial Hospital (Pekin Hospital)
• Pekin MRI, LLC
• Pekin Podiatric Medical Center, P.C
• Pekin Prescription Laboratory, Inc.
• Pekin Prohealth Inc
• Pekin Prohealth Inc (Park Court Pharmacy)
• Pekin Prohealth Inc
• Pekin Public School Dist 108
• Pekin Supportive Living Limited Patnership (John M Evans SLC)
• Katherine J Pena, OCCUP THERAPIST

• Radiology Clinic/Center in Pekin, IL
• Providers in Pekin, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.