John C. Proctor Endowment

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1810084 Issued in IL

Legal business name

JOHN C. PROCTOR ENDOWMENT

Practice address

2724 W Reservoir Blvd
Peoria, IL 61615-4137

Phone

(309) 566-4292

NPI assigned

May 28, 2008

Last updated

May 28, 2008By 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

Mr. John G Sahn

Title

Administrator/Ceo

Phone

(309) 685-6580

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1932367836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 W RESERVOIR BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616154137",
            "telephone_number": "309-566-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 W RESERVOIR BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616154137",
            "telephone_number": "309-566-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. PROCTOR ENDOWMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "SAHN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "309-685-6580",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1810084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurence Jiang, M.D.
• Jie Jiao, PH.D.
• Anna Jijo
• Jody L. Kelly M.D. & Associates, LLC (Jody L. Kelly M.D. & Associates, LLC - North)
• John B. Dale, DMD, Ms, P.C.
• John Day & Associates, LTD
• John P Gysin OD
• Jisha M John, PHARM D.
• Johnson Family Chiropractic of Peoria, PC
• Amanda J Johnson, SPEECH THERAPIST

• Skilled Nursing Facility in Peoria, IL
• Providers in Peoria, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.