EVERGREEN PLACE OF STREATOR SUPPORTIVE LIVING
NPI 1295980852
Assisted Living Facility in Streator, IL

Q: What is Evergreen Streator, L.P.'s NPI number?

The NPI number for Evergreen Streator, L.P. is 1295980852. It was assigned to this organization in the NPPES registry on November 24, 2008. The provider is doing business as Evergreen Place Of Streator Supportive Living.

Q: What is Evergreen Streator, L.P.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 24, 2008CLIA 14D2194739 · Waiver

1529 E MAIN ST, STREATOR, IL 61364(815) 672-0903(815) 672-0639 Get Directions Write a Review

NPPES record last updated: November 24, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Evergreen Place Of Streator Supportive Living NPPES

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

EVERGREEN PLACE OF STREATOR SUPPORTIVE LIVING (NPI 1295980852) is a healthcare organization registered as an assisted living facility in Streator, Illinois and active in the NPI registry since November 2008. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Craig L. Ater, Senior V.p. Of Finance, as its authorized official.

NPPES Registry Identity

NPI1295980852

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEVERGREEN STREATOR, L.P.

Location Address1529 E MAIN STStreator, IL 61364-3162

Mailing Address115 W Jefferson St, Ste 401, Po Box 3188Bloomington, IL 61701-3946 · (309) 823-7155 · Fax (309) 829-9512

Phone(815) 672-0903

Fax(815) 672-0639

Organization SubpartNo

Authorized OfficialCraig L. AterSenior V.p. Of Finance · (309) 828-4361

Enumeration DateNovember 24, 2008

✔ NPI 1295980852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1529 E MAIN ST, Streator, IL 61364

Open in Google Maps ↗

Other Names 1

Doing Business AsEvergreen Place Of Streator Supportive Living

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2194739

Evergreen Place · Streator, IL

Active · expires Oct 1, 2026

CLIA Number14D2194739

Laboratory TypeSupportive Living Fac

Certificate Effective DateOctober 2, 2024

Certificate Expiration DateOctober 1, 2026

Laboratory DirectorKristie Finney

Laboratory Phone(815) 672-0903

Laboratory LocationEvergreen Place1529 E Main, Streator, IL 61364

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Evergreen Streator, L.P.'s NPI number?

The NPI number for Evergreen Streator, L.P. is 1295980852. It was assigned to this organization in the NPPES registry on November 24, 2008. The provider is doing business as Evergreen Place Of Streator Supportive Living.

Where is Evergreen Streator, L.P. located?

Evergreen Streator, L.P. is located at 1529 E Main St, Streator, IL 61364. The listed phone number is (815) 672-0903.

What is Evergreen Streator, L.P.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Evergreen Streator, L.P. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2194739) is associated with this NPI, valid through October 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Streator, L.P. was last updated on November 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.