MEDICARE: PETERSEN COMPANIES, LLC

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	314000000X	Skilled Nursing Facility	0049007	IL

General Provider Information

NPI Number	:	1871745059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETERSEN COMPANIES, LLC

Provider Business Mailing Address
First Line	:	830 W TRAILCREEK DR
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-1862
Country	:	US
Telephone Number	:	309-691-8113
Fax Number	:

Provider Business Practice Location Address
First Line	:	16827 1410 NORTH AVE
Second Line	:
City	:	PRINCETON
State	:	IL
Zip	:	61356-6871
Country	:	US
Telephone Number	:	309-691-8113
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MARK PETERSEN
Credential	:
Telephone Number	:	309-691-8113

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

Similar Medicare Providers

1780670224 — MIDWEST HEALTH OPERATIONS LLC
Practice Location Address:

16827 1410 NORTH AVE
PRINCETON, IL
61356-6871

Practice Phone: 815-875-1196
Practice Fax: 815-872-4408

1124021308 — JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Practice Location Address:

530 PARK AVE E
PRINCETON, IL
61356-3901

Practice Phone: 815-875-2811
Practice Fax: 815-876-4455

1427057728 — DR. MICHAEL H BERKSON M.D.
Practice Location Address:

530 PARK AVE E STE 306
PRINCETON, IL
61356-3903

Practice Phone: 815-876-3099
Practice Fax: 815-876-3003

1932191806 — JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Practice Location Address:

530 PARK AVE E
PRINCETON, IL
61356-3901

Practice Phone: 815-875-4114
Practice Fax: 815-875-4112

1407849904 — DR. LEONARD M. KACZOROWSKI M.D.
Practice Location Address:

530 PARK AVE E
PRINCETON, IL
61356

Practice Phone: 815-875-2811
Practice Fax:

1114910528 — KETAN PATEL MD
Practice Location Address:

530 PARK AVE E , STE 101
PRINCETON, IL
61356-3901

Practice Phone: 815-872-1221
Practice Fax: 815-872-2304

Directions to “PETERSEN COMPANIES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.