JULIA RACKLEY PERRY MEMORIAL HOSPITAL NPI 1578922050

NPI Information

NPI: 1578922050
Provider Name: JULIA RACKLEY PERRY MEMORIAL HOSPITAL

Doing Business As: PERRY MEMORIAL FAMILY HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
535 PARK AVE E
PRINCETON, IL
ZIP 61356
Phone: (815) 875-4531
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JULIA RACKLEY PERRY MEMORIAL HOSPITAL is a rural health clinic center in Princeton, IL. JULIA RACKLEY PERRY MEMORIAL HOSPITAL NPI is 1578922050. The provider is registered as an organization entity type.
The provider Is Doing Business As Perry Memorial Family Health Clinic.

The provider's business location address is:

535 PARK AVE E
PRINCETON, IL
ZIP 61356-901
Phone: (815) 875-4531
Fax: (815) 876-2118

The provider's authorized official is Jean Welte .
The authorized official title is Medical Staff Services Coordinator and has the following contact phone number (815) 876-2293.

The enumeration date for this NPI number is 2/12/2016 and was last updated on 3/18/2020.

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
1	261QR1300X	Clinic/Center	Rural Health	0001883	ILLINOIS	Yes

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
1	=========	MEDICAID	ILLINOIS

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: 4/28/2024

NPI Synchronization or Removal

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