Pioneer Center

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PIONEER CENTER

Practice address

310 Constitution Drive Sowth West
Poplar Grove, IL 61065

Phone

(815) 800-1196

NPI assigned

May 9, 2016

Last updated

May 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shahalonie HermanNPI 1659724995

Title

Qidp Supervisor

Phone

(815) 904-1327

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Shahalonie Herman

  • Clinical Social Worker
  • Machesney Park, IL
  • NPI 1659724995
  Authorized official Same address or phone

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1902252075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CONSTITUTION DRIVE SOUTH WEST",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "61065",
            "telephone_number": "815-800-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CONSTITUTION DRIVE SOWTH WEST",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "61065",
            "telephone_number": "815-800-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "SHAHALONIE",
        "authorized_official_title_or_position": "QIDP SUPERVISOR",
        "authorized_official_telephone_number": "815-904-1327"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Boone Cusd 200
• North Boone Fire District 3
• Maegan O'Brien, MS CCC-SLP
• Bernard Edward O'Malley, MD
• Marykay Petges, RN
• Poplar Grove Chiropractic
• Poplar Grove Natural Health Center Inc
• Poplar Grove Natural Health Center SC
• Poplar Grove Physical Therapy, Inc. (CORA Physical Therapy - Poplar Grove)
• Sherry Ramos, LCPC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Grove, IL
• Providers in Poplar Grove, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.