NPIMap

Organization Active NPI

Children'S Home Association of Illinois

  • Community/Behavioral Health Agency
  • Peoria, IL
National Provider Identifier
1740632546
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
004259-13 Issued in IL
Legal business name
CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Practice address
2011 N Knoxville Ave
Peoria, IL 61603-2414
Phone
(309) 685-1047
Fax
(309) 687-7299
NPI assigned
Jul 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Authorized official

Name
Matt George
Title
Ceo
Phone
(309) 687-7218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 004259-13 IL Primary

Addresses

Primary practice location

2011 N Knoxville Ave
Peoria, IL 61603-2414

Mailing address

2130 N Knoxville Ave
Peoria, IL 61603-2460
Phone (309) 685-1047

Other identifiers 1

IdentifierTypeStateIssuer
2B05-IPI-130MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Children'S Home Association of Illinois20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1740632546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616032460",
            "telephone_number": "309-685-1047",
            "fax_number": "309-687-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616032414",
            "telephone_number": "309-685-1047",
            "fax_number": "309-687-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOME ASSOCIATION OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-687-7218"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "004259-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2B05-IPI-130",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.