# PROCTOR COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Proctor Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457679581
- **Authorized official:** MS. DEBORAH R. SIMON (PRESIDENT/CEO)
- **Authorized official phone:** (309) 672-5928

## Contact information

- **Practice address:** 5409 N KNOXVILLE AVE, PEORIA, IL 61614-5069
- **Practice address phone:** (309) 691-1000
- **Practice address fax:** (309) 671-8265
- **Mailing address:** 5409 N KNOXVILLE AVE, PEORIA, IL 61614-5069
- **Mailing address phone:** (309) 672-4813
- **Mailing address fax:** (309) 671-8265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 0001925 | IL | Yes |
| 276400000X | Substance Use Disorder Rehabilitation Hospital Unit | 1927324 | IL | — |

## Other

- **Enumeration date:** 05/13/2010
- **Last updated:** 02/13/2023