Provider Demographics
NPI:1013288646
Name:ST. MARGARET'S HEALTH-PERU
Entity type:Organization
Organization Name:ST. MARGARET'S HEALTH-PERU
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICIAN PRACTICES
Authorized Official - Prefix:
Authorized Official - First Name:DORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-780-3222
Mailing Address - Street 1:1305 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-2759
Mailing Address - Country:US
Mailing Address - Phone:815-223-3500
Mailing Address - Fax:815-780-4634
Practice Address - Street 1:220 E HIGH ST
Practice Address - Street 2:
Practice Address - City:HENNEPIN
Practice Address - State:IL
Practice Address - Zip Code:61327-9424
Practice Address - Country:US
Practice Address - Phone:815-925-7032
Practice Address - Fax:815-925-7463
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARGARET'S HEALTH-PERU
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-12
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty