NPIMap

Organization Active NPI

Julia Rackley Perry Memorial Hospital

  • Podiatric Clinic/Center
  • Princeton, IL
National Provider Identifier
1952877243
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Practice address
530 Park Ave E Ste 303
Princeton, IL 61356-3903
Phone
(815) 872-3034
Fax
(815) 872-3019
NPI assigned
Oct 15, 2018
Organization subpart
Yes
Parent organization
JULIA RACKLEY PERRY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

530 Park Ave E Ste 303
Princeton, IL 61356-3903

Mailing address

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 876-4419

Other names 1

  • Perry Memorial Podiatry Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Perry Mem Hosp Cardiolo5 organizations share this tax ID, including this one
Part of
Perry Mem Hosp Cardiolo

Other organizations with this tax ID 4

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

Locations

530 Park Ave E
Ste 202
Princeton, IL 61356
Phone (815) 872-3034

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1952877243",
    "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": "815-876-4419",
            "fax_number": "815-876-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E STE 303",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563903",
            "telephone_number": "815-872-3034",
            "fax_number": "815-872-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "enumeration_date": "2018-10-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Memorial Podiatry Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry Memorial Podiatry Clinic",
            "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 Jun 15, 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.