FONDULAC REHABILITATION & HEALTH CARE CENTER
NPI 1235176504
Skilled Nursing Facility in East Peoria, IL

NPI Status: Active since June 02, 2006

Contact Information

901 ILLINI DR
EAST PEORIA, IL
ZIP 61611
Phone: (309) 694-6446
Fax: (309) 694-8705

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  • Organization
  • Skilled Nursing Facility

About FONDULAC REHABILITATION & HEALTH CARE CENTER

This page provides the complete NPI Profile along with additional information for Fondulac Rehabilitation & Health Care Center, a provider established in East Peoria, Illinois operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1235176504 assigned on June 2006. The practitioner's primary taxonomy code is 314000000X with license number 0047472 (IL). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Fondulac Rehabilitation & Health Care Center. The authorized official of this NPI record is Mark B. Petersen (General Manager)

NPI
1235176504
Provider Legal Name
PETERSEN HEALTH OPERATIONS, LLC
Other Organization Name
FONDULAC REHABILITATION & HEALTH CARE CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
901 ILLINI DR EAST PEORIA, IL 61611
Location Phone
(309) 694-6446
Location Fax
(309) 694-8705
Mailing Address
830 W TRAILCREEK DR PEORIA, IL 61614
Mailing Phone
(309) 691-8113
Mailing Fax
(309) 694-8705
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-02-2006
Last Update Date
01-19-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
0047472
License State
IL
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARK B. PETERSEN

Authorized Official Title
GENERAL MANAGER
Authorized Official Phone
(309) 691-8113

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235176504, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
5
Unchanged
Pos 9
0
Doubled → 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 1 → 2 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 2 + 7 + 1 + 2 + 5 + 0 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1235176504.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Speech-Language Pathologist
901 ILLINI DR
EAST PEORIA, IL 61611
Skilled Nursing Facility
901 ILLINI DR
EAST PEORIA, IL 61611
Occupational Therapist
901 ILLINI DR
EAST PEORIA, IL 61611

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235176504, enumerated as an "organization" on June 02, 2006.

The provider is located at 901 ILLINI DR EAST PEORIA, IL 61611 and the phone number is (309) 694-6446.

Skilled Nursing Facility with taxonomy code 314000000X.