NPIMap

Organization Active NPI

Julia Rackley Perry Memorial Hospital

  • Anesthesiology Physician
  • Princeton, IL
National Provider Identifier
1891752010
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Practice address
530 Park Ave E
Princeton, IL 61356-3901
Phone
(815) 875-2811
Fax
(815) 876-4455
NPI assigned
May 1, 2006
Organization subpart
Yes
Parent organization
JULIA RACKLEY PERRY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Ms. Jean Welte
Title
Medical Staff Services Coordinator
Phone
(815) 876-2293

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

530 Park Ave E
Princeton, IL 61356-3901

Mailing address

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 875-2811

Other names 1

  • PMH Anesthesia Doing business as

National Provider Directory

National Provider Directory
Part of
Perry Mem Hosp Cardiolo

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1891752010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-875-2811",
            "fax_number": "815-876-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-875-2811",
            "fax_number": "815-876-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "WELTE",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "MEDICAL STAFF SERVICES COORDINATOR",
        "authorized_official_telephone_number": "815-876-2293",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PMH Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PMH Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.