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PEORIA SITE 014030
NPI 1104154277
Foster Care Agency in Peoria, IL

Active since November 30, 2009
4507 N STERLING AVE, PEORIA, IL 61615(309) 676-6131(309) 676-5655 Get Directions Write a Review

NPPES record last updated: December 3, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Peoria Site 014030 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEORIA SITE 014030 (NPI 1104154277) is a healthcare organization registered as a foster care agency in Peoria, Illinois and active in the NPI registry since November 2009. The organization lists Viviane Ngwa, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104154277
Entity TypeOrganization
Primary Taxonomy253J00000X
Legal Business NameILLINOIS MENTOR
Location Address4507 N STERLING AVEPeoria, IL 61615-3824
Mailing Address4507 N Sterling AvePeoria, IL 61615-3824 · (309) 676-6131 · Fax (309) 676-5655
Phone(309) 676-6131
Fax(309) 676-5655
Organization SubpartYes
Authorized OfficialViviane NgwaExecutive Director · (708) 679-9137
Enumeration DateNovember 30, 2009
Last NPPES UpdateDecember 3, 2010
✔ NPI 1104154277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFoster Care AgencyAgencies
Taxonomy Code253J00000X
Definition
A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as 24-hour substitute care for children outside their own homes. Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X
4507 N STERLING AVE, Peoria, IL 61615
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Other Names 1

Doing Business AsPeoria Site 014030

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TODD J KARAS DPM
Podiatrist
4507 N STERLING AVE, #102
PEORIA, IL 61615
Peoria County (309) 272-7322
TRUTH CHANGES US LLC
Substance Abuse Rehabilitation Facility
4507 N STERLING AVE
PEORIA, IL 61615
Peoria County (309) 339-5835
SCHUBACH COUNESLING, CONSULTING & TRAINING PLLC
Counselor (Professional)
4507 N STERLING AVE, SUITE 210
PEORIA, IL 61615
Peoria County (309) 657-1246
DR. GARY R. STAMM D.D.S.
Dentist (General Practice)
4507 N STERLING AVE, SUITE 306
PEORIA, IL 61615
Peoria County (309) 685-0444
TODD J KARAS DPM PC
Podiatrist
4507 N STERLING AVE, SUITE 102
PEORIA, IL 61615
Peoria County (309) 272-7322

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Illinois Mentor's NPI number?

The NPI number for Illinois Mentor is 1104154277. It was assigned to this organization in the NPPES registry on November 30, 2009. The provider is doing business as Peoria Site 014030.

Where is Illinois Mentor located?

Illinois Mentor is located at 4507 N Sterling Ave, Peoria, IL 61615. The listed phone number is (309) 676-6131.

What is Illinois Mentor's specialty?

The primary specialty registered for this NPI is Foster Care Agency with taxonomy code 253J00000X.

When was this NPI record last updated?

The NPPES record for Illinois Mentor was last updated on December 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.