PERU PRIMARY CARE PROFESSIONALS LLC NPI 1568591048

NPI Information

  • NPI: 1568591048
  • Provider Name: PERU PRIMARY CARE PROFESSIONALS LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 920 WEST ST
    SUITE 311
    PERU, IL
    ZIP 61354
  • Phone: (815) 223-9214

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NPI Details

PERU PRIMARY CARE PROFESSIONALS LLC is a family medicine in Peru, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PERU PRIMARY CARE PROFESSIONALS LLC NPI is 1568591048. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

920 WEST ST
SUITE 311
PERU, IL
ZIP 61354-763
Phone: (815) 223-9214
Fax: (815) 223-9322

The provider's authorized official is Mark A. Fernandez .
The authorized official title is Partner and has the following contact phone number (815) 223-9214.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 11/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine036089936ILLINOISNo
2208000000XPediatrics036089936ILLINOISNo
3207RG0300XInternal MedicineGeriatric Medicine036089936ILLINOISNo
4207Q00000XFamily Medicine036111100ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C52077MEDICARE UPIN
2K09062MEDICARE ID-TYPE UNSPECIFIED
3K08696MEDICARE ID-TYPE UNSPECIFIED
4H75096MEDICARE UPIN
5036111100MEDICAIDILLINOIS
6036089936MEDICAIDILLINOIS
7215096MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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