SMH-PERU/ADULT MEDICINE CLINIC – NPI #1063683977
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

SMH-PERU/ADULT MEDICINE CLINIC is an AHC clinic located in PERU, IL. NPPES has assigned the NPI number 1063683977 to SMH-PERU/ADULT MEDICINE CLINIC on March 19, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SMH-PERU/ADULT MEDICINE CLINIC” is a dba name, the actual legal business name for this organization is ST. MARGARET'S HEALTH-PERU. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

The NPI profile was previously updated about 5 years ago on Jan 28, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SMH-PERU/ADULT MEDICINE CLINIC below.

NPI Profile for
ST. MARGARET'S HEALTH-PERU

NPI Number
1063683977
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST. MARGARET'S HEALTH-PERU
Doing Business As (dba): SMH-PERU/ADULT MEDICINE CLINIC
Other name(s)
All associated names:
Doing Business As (dba)
IVCH MEDICAL GROUP / ADULT MEDICINE CLINIC
Doing Business As (dba)
SMH-Peru/Adult Medicine Clinic
Primary location
920 WEST ST STE 218
PERU, IL 61354-2769
Phone: (815) 780-3838 Fax: (815) 780-3836
Mailing address
1305 6TH ST
PERU, IL 61354-2759
Phone: (815) 780-4619 Fax: (815) 780-4634
Organization Subpart
Yes - SMH-PERU/ADULT MEDICINE CLINIC is subpart of another organization.
Authorized Official
DORI BONNELL
DIRECTOR OF PHYSICIAN PRACTICES
Phone: (815) 780-3222
Updated
Certification Date
Jan 28, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM2500X
- Clinic/Center / Medical Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.