MEDICARE: PEAK PROFESSIONAL HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	04132706	IL

General Provider Information

NPI Number	:	1679766349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK PROFESSIONAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	300 E 4TH ST
Second Line	:
City	:	ROCK FALLS
State	:	IL
Zip	:	61071-1349
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 4TH ST
Second Line	:
City	:	ROCK FALLS
State	:	IL
Zip	:	61071-1349
Country	:	US
Telephone Number	:	815-622-5938
Fax Number	:

Authorized Official
Title or Position	:	RN
Name	:	MS. ALVA CHRISTINE EDMONDSON
Credential	:
Telephone Number	:	815-622-5938

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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Directions to “PEAK PROFESSIONAL HEALTH SERVICES ” Practice Location

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