Petersen Companies, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0049890 Issued in IL

Legal business name

PETERSEN COMPANIES, LLC

Doing business as

Rochelle Rehabiliation & Health Care Center

Practice address

900 N 3Rd St
Rochelle, IL 61068-1666

Phone

(815) 562-4111

NPI assigned

Oct 21, 2008

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

Manager

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rochelle Rehabiliation & Health Care Center Doing business as

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1780836965",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 3RD ST",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610681666",
            "telephone_number": "815-562-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN COMPANIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0049890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205301712004",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochelle Rehabiliation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shazeen Pardesi, DDS
• Stacey J Patla
• Amanda Perez-Garcia, MD
• Lisa K Perino, PSY D
• Sharda Bramhawatie Persaud, PHARMD
• Petersen Health Network, LLC
• Petersen Health Network, LLC
• Physician Care at Home Management Company LLC
• Chad Monroe Piller, DC
• Jason C Popp, MD

• 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 Oct 21, 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.