COURTYARD ESTATES OF SULLIVAN
NPI 1598918385
Assisted Living Facility in Sullivan, IL

Q: What is Petersen Health Care II, Inc.'s NPI number?

The NPI number for Petersen Health Care II, Inc. is 1598918385. It was assigned to this organization in the NPPES registry on October 24, 2008. The provider is doing business as Courtyard Estates Of Sullivan.

Q: What is Petersen Health Care II, Inc.'s specialty?

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

Active since October 24, 2008CLIA 14D2192577 · Waiver

20 COURTYARD BOULEVARD, SULLIVAN, IL 61951(217) 728-4300(217) 728-2165 Get Directions Write a Review

NPPES record last updated: October 24, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Courtyard Estates Of Sullivan NPPES

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

COURTYARD ESTATES OF SULLIVAN (NPI 1598918385) is a healthcare organization registered as an assisted living facility in Sullivan, Illinois and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through September 10, 2026 and lists Mark B. Petersen, President, as its authorized official.

NPPES Registry Identity

NPI1598918385

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NamePETERSEN HEALTH CARE II, INC.

Location Address20 COURTYARD BOULEVARDSullivan, IL 61951-7001

Mailing Address830 W Trailcreek DrPeoria, IL 61614-1862 · (309) 691-8113 · Fax (309) 691-8622

Phone(217) 728-4300

Fax(217) 728-2165

Organization SubpartNo

Authorized OfficialMark B. PetersenPresident · (309) 691-8113

Enumeration DateOctober 24, 2008

✔ NPI 1598918385 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.

20 COURTYARD BOULEVARD, Sullivan, IL 61951

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Other Names 1

Doing Business AsCourtyard Estates Of Sullivan

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 14D2192577

Courtyard Estates Of Sullivan · Sullivan, IL

Active · expires Sep 10, 2026

CLIA Number14D2192577

Laboratory TypeAssisted Living Facility

Certificate Effective DateSeptember 11, 2024

Certificate Expiration DateSeptember 10, 2026

Laboratory DirectorMegan N. Graven

Laboratory Phone(217) 728-4300

Laboratory LocationCourtyard Estates Of Sullivan20 Courtyard Blvd, Sullivan, IL 61951

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 Petersen Health Care II, Inc.'s NPI number?

The NPI number for Petersen Health Care II, Inc. is 1598918385. It was assigned to this organization in the NPPES registry on October 24, 2008. The provider is doing business as Courtyard Estates Of Sullivan.

Where is Petersen Health Care II, Inc. located?

Petersen Health Care II, Inc. is located at 20 Courtyard Boulevard, Sullivan, IL 61951. The listed phone number is (217) 728-4300.

What is Petersen Health Care II, Inc.'s specialty?

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

Does Petersen Health Care II, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2192577) is associated with this NPI, valid through September 10, 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 Petersen Health Care II, Inc. was last updated on October 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.