St. Margaret'S Health-Peru

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ST. MARGARET'S HEALTH-PERU

Practice address

920 West St
Sutie 312
Peru, IL 61354-2763

Phone

(815) 223-4400

Fax

(815) 223-4401

NPI assigned

Jul 31, 2013

Organization subpart

Yes

Parent organization

ST. MARGARET'S HEALTH-PERUAs reported in NPPES

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

Authorized official

Name

Dori Bonnell

Title

Director of Physician Practices

Phone

(815) 780-3222

Specialties & licenses 1

Addresses

Other names 2

• IVCH Medical Group / ENT & Allergy Center Doing business as
• SMH-Peru/ENT & Allergy Center Doing business as

Part of

Ivch Immunization Clini

Locations

Practitioners 1

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

• Angela Marie Vezzetti, PA-C

  • Physician Assistant
  • Peru, IL
  • NPI 1699005678
  NPD (past)

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1831521947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 6TH ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542759",
            "telephone_number": "815-780-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST ST",
            "address_2": "SUTIE 312",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542763",
            "telephone_number": "815-223-4400",
            "fax_number": "815-223-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARGARET'S HEALTH-PERU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARGARET'S HEALTH-PERU",
        "enumeration_date": "2013-07-31",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "BONNELL",
        "authorized_official_first_name": "DORI",
        "authorized_official_title_or_position": "DIRECTOR OF PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "815-780-3222"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVCH Medical Group / ENT & Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IVCH Medical Group / ENT & Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMH-Peru/ENT & Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru

• All providers in Peru, IL
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.