Organization
CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE SIEBERT (DIRECTOR OF COMPLIANCE)
(309) 687-7440
Entity
Organization
Contact information
Practice address
7225 W PLANK RD, PEORIA, IL 61604-5252
(309) 687-7241
Mailing address
2130 N KNOXVILLE AVE, PEORIA, IL 61603-2460
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A-6162-0001-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-130
—
IL
05
—
A-6162-0001-A
—
IL
Enumeration date
08/29/2017
Last updated
04/11/2025
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