NPIMap

Organization Active NPI

Illinois Valley Autism Center

  • Community/Behavioral Health Agency
  • Peru, IL
National Provider Identifier
1811264526
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ILLINOIS VALLEY AUTISM CENTER
Practice address
4401 Progress Blvd
Peru, IL 61354-1109
Phone
(815) 200-6751
NPI assigned
Nov 23, 2011
Last updated
Aug 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Mrs. Cindy Bennett
Title
Director
Phone
(815) 200-6751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4401 Progress Blvd
Peru, IL 61354-1109

Mailing address

4401 Progress Blvd
Peru, IL 61354-1109
Phone (815) 200-6751

National Provider Directory

National Provider Directory

Locations

4401 Progress Blvd
Peru, IL 61354
Phone (815) 200-6751

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1811264526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541109",
            "telephone_number": "815-200-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541109",
            "telephone_number": "815-200-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS VALLEY AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "815-200-6751",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.