Illini Heritage Rehab & Health Care – Skilled Nursing Facility, NPI 1619083730

Illini Heritage Rehab & Health Care is a healthcare provider. based in Peoria, Illinois. specializing in Skilled Nursing Facility. The organization holds a License No. 0042440 (IL). The NPI Number for Illini Heritage Rehab & Health Care is 1619083730

Main info

Organization
Name
Illini Heritage Rehab & Health Care
NPI
1619083730
Phone
(309) 691-8113
Address
830 W. TRAILCREEK DRIVE
Authorized Official
MARK B. PETERSEN PRESIDENT
Enumeration Date
22 August 2006
Last Update Date
14 February 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Illini Heritage Rehab & Health Care

  • 830, West Trailcreek Drive, Peoria, Peoria County, Illinois, 61614, United States

    PEORIA, IL 61614

    Phone: (309) 691-8113

    Fax: (309) 691-8622

    Type: Mailing

  • 1315, Curt Drive, Dobbins Downs, Champaign, Champaign County, Illinois, 61821, United States

    CHAMPAIGN, IL 61820

    Phone: (217) 352-5707

    Fax: (217) 352-2607

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1044 days ago).

Enrollment records

1

Earliest due date

2023-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20111220000292OMass Immunization (Roster Biller Only)IL2023-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61614)

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Reviews

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Frequently asked questions

Does Illini Heritage Rehab & Health Care have a public NPI I can cite?
Public records show Illini Heritage Rehab & Health Care under NPI 1619083730.
Should I treat Illini Heritage Rehab & Health Care as an active provider?
Patients and plans typically see Illini Heritage Rehab & Health Care as active in the national extract.
How should patients interpret Illini Heritage Rehab & Health Care's specialty?
The extract shows Skilled Nursing Facility for Illini Heritage Rehab & Health Care. Clinical services aligned with this taxonomy classification.
Which community is linked to Illini Heritage Rehab & Health Care?
Illini Heritage Rehab & Health Care shows a connection to Peoria, Illinois in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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