NPIMap

Organization Active NPI

Travel Center Clinics

  • Clinic/Center
  • Peru, IL
National Provider Identifier
1891976296
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TRAVEL CENTER CLINICS
Practice address
3130 May Rd
Peru, IL 61354-9618
Phone
(815) 224-7971
Fax
(615) 661-8977
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Mrs. Colleen A Adams
Title
Billing Manager
Phone
(615) 661-8929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3130 May Rd
Peru, IL 61354-9618

Mailing address

PO Box 51525
Knoxville, TN 37950-1525
Phone (615) 661-8929

Other names 1

  • PROFESSIONAL DRIVERS MEDICAL DEPOTS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Drivers Medical Depot7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3130 May Rd
Peru, IL 61354
Phone (815) 224-7971

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1891976296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51525",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379501525",
            "telephone_number": "615-661-8929",
            "fax_number": "615-661-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 MAY RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613549618",
            "telephone_number": "815-224-7971",
            "fax_number": "615-661-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVEL CENTER CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "615-661-8929",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL DRIVERS MEDICAL DEPOTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 14, 2007; 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.