St. Margaret'S Health-Peru

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST. MARGARET'S HEALTH-PERU

Doing business as

IVCH MEDICAL GROUP / LaSalle Medical Clinic
SMH-Peru/LaSalle Medical Clinic

Practice address

128 Bucklin St
La Salle, IL 61301-2389

Phone

(815) 220-7170

NPI assigned

Jul 25, 2011

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 2

Addresses

Other names 2

• IVCH MEDICAL GROUP / LaSalle Medical Clinic Doing business as
• SMH-Peru/LaSalle Medical Clinic Doing business as

Part of

Ivch Immunization Clini

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1861770802",
    "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": "128 BUCKLIN ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012389",
            "telephone_number": "815-220-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARGARET'S HEALTH-PERU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARGARET'S HEALTH-PERU",
        "enumeration_date": "2011-07-25",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVCH MEDICAL GROUP / LaSalle Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IVCH MEDICAL GROUP / LaSalle Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMH-Peru/LaSalle Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abbey Slusarski, LCSW
• Patrick R Smith, DC
• Speech Suite 815
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru
• St. Margaret'S Health-Peru (IVCH MEDICAL GROUP/ LaSalle Medical Clinic)
• Mark M. Stahnke, M.DIV.
• Anita Stegall
• Danielle G Stoddard, LCPC
• Amanda Stone

• Family Medicine Physician in La Salle, IL
• Providers in La Salle, IL by specialty
• Family Medicine Physician 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.