Two Harbors Integrative Healthcare, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

209.001386 Issued in IL

Legal business name

TWO HARBORS INTEGRATIVE HEALTHCARE, LLC

Practice address

2220 Marquette Rd
Peru, IL 61354-1555

Phone

(815) 343-0771

Fax

(888) 303-1960

NPI assigned

Apr 21, 2015

Last updated

Jul 10, 2015By 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

Catherine A ChristensenNPI 1407936040

Title

Owner

Phone

(815) 343-0771

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Catherine A Christensen, RN, WHCNP, CNM

  • Women's Health Nurse Practitioner
  • Peru, IL
  • NPI 1407936040
  Authorized official Same address or phone

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1902293657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "SHEFFIELD",
            "state": "IL",
            "postal_code": "613610014",
            "telephone_number": "815-343-0771",
            "fax_number": "888-303-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 MARQUETTE RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541555",
            "telephone_number": "815-343-0771",
            "fax_number": "888-303-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO HARBORS INTEGRATIVE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-343-0771"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "209.001386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470965971001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Peru, IL
• Providers in Peru, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.